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  • Question 1 - 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: Decreased platelet count

      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
      13.5
      Seconds
  • Question 2 - By the third day of wound healing, which sort of inflammatory cell has...

    Incorrect

    • By the third day of wound healing, which sort of inflammatory cell has predominated:

      Your Answer:

      Correct Answer: Macrophages

      Explanation:

      The inflammatory phase of healing is sometimes called the lag phase because wound strength does not begin to return immediately. The inflammatory phase is completed within three days except in the presence of infection or other factors associated with impaired wound healing. Mononuclear leukocytes accumulate and are transformed into macrophages. The maturation of blood-derived monocytes into macrophages is heralded by several events, including secretion of vimentin, which is a structural filament protein involved in wound healing.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      0
      Seconds
  • Question 3 - Regarding gastric motility and emptying, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding gastric motility and emptying, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Gastric emptying is inhibited by the presence of the products of fat digestion in the duodenum.

      Explanation:

      Gastric emptying is decreased by the presence of fats in the duodenum (by stimulating release of cholecystokinin). Mixing of the food with gastric secretions takes place in the distal body and antrum of the stomach where the muscularis externa layer is thicker. The stomach has an additional inner oblique smooth muscle layer (in addition to the inner circular layer and outer longitudinal layer). Gastric emptying is increased by a low gastric pH and decreased by a low duodenal pH.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds
  • Question 4 - You examine a 72-year-old man who has recently begun bumetanide treatment for worsening...

    Incorrect

    • You examine a 72-year-old man who has recently begun bumetanide treatment for worsening heart failure.

      Which of these statements about bumetanide is correct?

      Your Answer:

      Correct Answer: It has better intestinal absorption than furosemide

      Explanation:

      Bumetanide is a loop diuretic that is used to treat congestive heart failure. It is frequently used in patients who have failed to respond to high doses of furosemide.

      It has a potency of about 40 times that of furosemide, with a 1 mg dose being roughly equivalent to a 40 mg dose of furosemide.
      Seizures are not known to be triggered by bumetanide. In fact, it lowers the concentration of neuronal chloride, making GABA’s action more depolarizing, and it’s currently being tested as an antiepileptic in the neonatal period.

      It takes effect after 1 hour of oral administration, and diuresis takes 6 hours to complete.

      Bumetanide absorbs much better in the intestine than furosemide. Because it has a higher bioavailability than furosemide, it is commonly used in patients with gut oedema.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 5 - Which of the following causes increased aldosterone secretion: ...

    Incorrect

    • Which of the following causes increased aldosterone secretion:

      Your Answer:

      Correct Answer: Decreased blood volume

      Explanation:

      Decreased blood volume stimulates the secretion of renin (because of decreased renal perfusion pressure) and initiates the renin-angiotensin-aldosterone cascade. Angiotensin-converting enzyme (ACE) inhibitors block the cascade by decreasing the production of angiotensin. Hyperosmolarity stimulates antidiuretic hormone (ADH) [not aldosterone] secretion. Hyperkalaemia, not hypokalaemia, directly stimulates aldosterone secretion by the adrenal cortex. ANP inhibits renin secretion, thereby inhibiting the production of angiotensin and aldosterone.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 6 - A 24-year-old student with red and painful right eye presents. Conjunctival erythema, mucopurulent...

    Incorrect

    • A 24-year-old student with red and painful right eye presents. Conjunctival erythema, mucopurulent discharge and lid crusting are seen on examination, and patient denies presence of itching of the eye. All his observations are normal, he has no fever and is otherwise well.

      Which of these is the most likely causative organism?

      Your Answer:

      Correct Answer: Haemophilus influenzae

      Explanation:

      The most frequent cause of red eye is conjunctivitis. It is caused by inflammation of the conjunctiva which can be infective or allergic and accounts for about 35% of all eye problems presenting to general practice.

      Viral conjunctivitis is commonly caused by adenoviruses and it is the most common infectious conjunctivitis.

      The common bacterial causes of conjunctivitis are Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.

      The clinical features of infective conjunctivitis include:
      Acute onset of conjunctival erythema
      Feeling ‘grittiness’, ‘foreign body’ or ‘burning’ sensation in the eye.
      Watering and discharge which may cause transient blurring of vision

      The discharge for viral conjunctivitis is less than that of bacterial conjunctivitis and usually watery.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 7 - A 73-year-old woman arrives at the emergency department 48 hours after being discharged from...

    Incorrect

    • A 73-year-old woman arrives at the emergency department 48 hours after being discharged from the hospital after a two-week stay for sepsis treatment. She has fever, productive cough with thick green sputum, and shortness of breath. An X-ray shows left lower lobe pneumonia. Which of the bacteria listed below is more likely to be the causative agent:

      Your Answer:

      Correct Answer: Pseudomonas aeruginosa

      Explanation:

      Hospital-acquired pneumonia (HAP), or nosocomial pneumonia, is a lower respiratory infection that was not incubating at the time of hospital admission and that presents clinically 2 or more days after hospitalization. Pneumonia that presents sooner should be regarded as community­ acquired pneumonia. VAP refers to nosocomial pneumonia that develops among patients on ventilators. Ventilator-associated pneumonia (VAP) is defined as pneumonia that presents more than 48 hours after endotracheal intubation.

      Common bacteria involved in hospital-acquired pneumonia (HAP) include the following [10] :
      Pseudomonas Aeruginosa
      Staphylococcus aureus, including methicillin-susceptible S aureus (MSSA) and methicillin-resistant S aureus (MRSA)
      Klebsiella pneumoniae
      Escherichia coli

    • This question is part of the following fields:

      • Infections
      • Microbiology
      0
      Seconds
  • Question 8 - A 29-year-old man presents with painful red eye with copious discharge and you...

    Incorrect

    • A 29-year-old man presents with painful red eye with copious discharge and you make a diagnosis of infective conjunctivitis following a history and an examination,.

      One of these is NOT an indication for an urgent ophthalmology referral in this patient.

      Your Answer:

      Correct Answer: Bilateral conjunctivitis

      Explanation:

      Urgent referral to ophthalmology is indicated if the patient with conjunctivitis has any of the following:

      Suspected gonococcal or chlamydial conjunctivitis
      Corneal involvement associated with soft contact lens use
      Severe disease indicated by presence of a pseudomembrane
      Conjunctivitis associated with rheumatoid arthritis or in immunocompromised patient. Ophthalmia neonatorum.
      Possible herpes infection.
      Had recent intraocular surgery. A red flag indicating a serious cause of red eye.
      Suspected periorbital or orbital cellulitis.

      Bilateral conjunctivitis is not an indication for urgent referral to ophthalmology.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 9 - A 45-year old man presented to the emergency room with complains of chest...

    Incorrect

    • A 45-year old man presented to the emergency room with complains of chest pain and breathlessness. Upon history taking and examination, it was discovered that he had a right-sided spontaneous pneumothorax and had a failed attempt at pleural aspiration. The pneumothorax is still considerable in size, but he remains breathless. A Seldinger chest drain was inserted but it started to drain frank blood shortly after.

      Which of the following complications is most likely to have occurred?

      Your Answer:

      Correct Answer: Intercostal artery laceration

      Explanation:

      Injury to the intercostal artery (ICA) is an infrequent but potentially life-threatening complication of all pleural interventions.

      Traditional anatomy teaching describes the ICA as lying in the intercostal groove, protected by the flange of the rib. This is the rationale behind the recommendation to insert needles just above the superior border of the rib. Current recommendations for chest drain insertion suggest that drains should be inserted in the ‘safe triangle’ in order to avoid the heart and the mediastinum and be above the level of the diaphragm.

      The safe triangle is formed anteriorly by the lateral border of the pectoralis major, laterally by the lateral border of the latissimus dorsi, inferiorly by the line of the fifth intercostal space and superiorly by the base of the axilla. Imaging guidance also aids in the safety of the procedure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 10 - The following statements are not true of the flexor digiti minimi brevis, except?...

    Incorrect

    • The following statements are not true of the flexor digiti minimi brevis, except?

      Your Answer:

      Correct Answer: It is situated on the radial border of abductor digiti minimi

      Explanation:

      Flexor digiti minimi brevis muscle is located on the ulnar side of the palm, lying on the radial border of the abductor digiti minimi. Together with the abductor digiti minimi and opponens digiti minimi muscles, it forms the hypothenar eminence. The muscle is situated inferior and lateral to adductor digiti minimi muscle and superior and medial to opponens digiti minimi muscle. The proximal parts of flexor digiti minimi brevis and abductor digiti minimi muscles form a gap through which deep branches of the ulnar artery and ulnar nerve pass.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 11 - Which of the following statements is correct regarding hyponatraemia? ...

    Incorrect

    • Which of the following statements is correct regarding hyponatraemia?

      Your Answer:

      Correct Answer: Correction of serum sodium that is too rapid can precipitate central pontine myelinolysis.

      Explanation:

      Hyponatraemia refers to a serum sodium concentration < 135 mmol/L.
      It is safer to quickly correct acute hyponatremia than chronic hyponatremia but correction should not be too fast, especially in chronic hyponatraemia, because of the risk of central pontine myelinolysis. Hyponatraemia is usually associated with a low plasma osmolality.
      Under normal circumstances, if serum osmolality is low, then urine osmolality should also be low because the kidneys should be trying to retain solute.
      In SIADH, excess ADH causes water retention, but not the retention of solute. Therefore, urine that is concentrated and relatively high in sodium is produced, even though the serum sodium is low (urine osmolality > 100 mosmol/kg).

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 12 - Needle thoracentesis in a patient with a tension pneumothorax is performed at which...

    Incorrect

    • Needle thoracentesis in a patient with a tension pneumothorax is performed at which anatomical landmark?

      Your Answer:

      Correct Answer: 4th or 5th intercostal space mid-axillary line

      Explanation:

      Tension pneumothorax is a fatal disease causing acute and severe compromise of patients’ ventilation and circulation, in which case immediate decompression is necessary for better prognosis [6]. A previous study has shown that the incidence of tension pneumothorax varies from 0.2% to 1.7% in patients with prehospital trauma. Several trauma guidelines recommend needle thoracostomy as a life-saving intervention, with placement in the second intercostal space at the midclavicular line (second ICS-MCL), the fourth intercostal space at the anterior axillary line (fourth ICS-AAL), or the fifth intercostal space at the midaxillary line (fifth ICS-MAL) for tension pneumothorax in a prehospital environment.

      In 2018, according to newly issued the Advanced Trauma Life Support (ATLS) guidelines, the fifth ICS-MAL was suggested as the preferred place, and an 8 cm needle rather than the common 5 cm needle was proved to increase success rate of adults’ decompression.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 13 - Which of the following is NOT a typical feature of a lesion to...

    Incorrect

    • Which of the following is NOT a typical feature of a lesion to the vestibulocochlear nerve:

      Your Answer:

      Correct Answer: Hyperacusis

      Explanation:

      Hyperacusis is increased acuity of hearing with hypersensitivity to low tones resulting from paralysis of the stapedius muscle, innervated by the facial nerve. General sensation to the face and to the anterior two-thirds of the tongue is carried by the divisions of the trigeminal nerve (although taste to the anterior two-thirds of the tongue is supplied by the facial nerve). Eye movements are mediated by the oculomotor, trochlear and abducens nerve. Ptosis results from paralysis of the levator palpebrae superioris, innervated by the oculomotor nerve, or the superior tarsal muscle, innervated by the sympathetic chain.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      0
      Seconds
  • Question 14 - During swallowing, which of the following structures primarily closes the tracheal opening: ...

    Incorrect

    • During swallowing, which of the following structures primarily closes the tracheal opening:

      Your Answer:

      Correct Answer: Epiglottis

      Explanation:

      The vocal cords of the larynx are strongly
      approximated, and the larynx is pulled upward
      and anteriorly by the neck muscles. These actions,
      combined with the presence of ligaments that
      prevent upward movement of the epiglottis, cause
      the epiglottis to swing back over the opening
      of the larynx. All these effects acting together
      prevent the passage of food into the nose and
      trachea. Most essential is the tight approximation
      of the vocal cords, but the epiglottis helps to
      prevent food from ever getting as far as the vocal
      cords. Destruction of the vocal cords or of the
      muscles that approximate them can cause
      strangulation.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds
  • Question 15 - Intrinsic factor is secreted by which of the following cell types in the...

    Incorrect

    • Intrinsic factor is secreted by which of the following cell types in the stomach:

      Your Answer:

      Correct Answer: Parietal cells

      Explanation:

      Intrinsic factor is essential for the absorption of the small amounts of vitamin B12 normally present in the diet from the terminal ileum. The parietal cells of the stomach produce intrinsic factor, and following a gastrectomy, the absorption of vitamin B12 will be markedly reduced, and a deficiency state will exist.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds
  • Question 16 - What is the pathophysiology of a phaeochromocytoma: ...

    Incorrect

    • What is the pathophysiology of a phaeochromocytoma:

      Your Answer:

      Correct Answer: Catecholamine-secreting tumour

      Explanation:

      Phaeochromocytomas are catecholamine-secreting tumours which occur in about 0.1% of patients with hypertension. In about 90% of cases they arise from the adrenal medulla. The remaining 10%, which arise from extra-adrenal chromaffin tissue, are termed paragangliomas. Common presenting symptoms include one or more of headache, sweating, pallor and palpitations. Less commonly, patients describe anxiety, panic attacks and pyrexia. Hypertension, whether sustained or episodic, is present in at least 90% of patients. Left untreated phaeochromocytoma can occasionally lead to hypertensive crisis, encephalopathy, hyperglycaemia, pulmonary oedema, cardiac arrhythmias, or even death.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 17 - The following structures all lie anteriorly to the oesophagus EXCEPT for the: ...

    Incorrect

    • The following structures all lie anteriorly to the oesophagus EXCEPT for the:

      Your Answer:

      Correct Answer: Thoracic duct

      Explanation:

      Posterior to the oesophagus, the thoracic duct is on the right side inferiorly but crosses to the left more superiorly (at T5).

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 18 - Which of the following muscles is least likely to be involved in forceful expiration:...

    Incorrect

    • Which of the following muscles is least likely to be involved in forceful expiration:

      Your Answer:

      Correct Answer: External intercostal muscles

      Explanation:

      Forceful expiration is primarily produced by the deeper thoracic muscles (internal and innermost intercostal muscles, subcostals and transversus thoracis) aided by contraction of the abdominal wall muscles which increase intra-abdominal pressure thus further reducing the volume of the thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 19 - After collapsing at home, a 62-year-old man is transported in an ambulance. He...

    Incorrect

    • After collapsing at home, a 62-year-old man is transported in an ambulance. He is now awake, but he is experiencing palpitations and chest pain. He is rushed to resuscitation and placed on a cardiac monitor, which reveals ventricular tachycardia. An amiodarone infusion is set up.

      Which of these statements about amiodarone is correct?

      Your Answer:

      Correct Answer: It is expressed in breast milk

      Explanation:

      Antiarrhythmic drug amiodarone is used to treat both ventricular and atrial arrhythmias. It’s a class III antiarrhythmic that works by prolonging the repolarization phase of the cardiac action potential, where potassium permeability is normally high and calcium permeability is low.

      Dronedarone is sometimes used instead of amiodarone in certain situations. Although amiodarone is more effective than dronedarone, dronedarone has fewer side effects.

      Grapefruit juice inhibits the metabolism of amiodarone.

      The plasma half-life of amiodarone is very long, ranging from 2 weeks to 5 months. The half-life is about 2 months on average.
      Because amiodarone is excreted in breast milk, it should be avoided by breastfeeding mothers.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 20 - Regarding hepatitis C, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding hepatitis C, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Anti-HCV IgG antibodies are diagnostic of acute infection.

      Explanation:

      Anti-HCV IgG antibodies indicate exposure to hepatitis C but this could be acute, chronic or resolved infection. If the antibody test is positive, HCV RNA should be tested for, which if positive indicates that a person has current infection with active hepatitis C.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 21 - A patient is referred for lung function tests on account of a history...

    Incorrect

    • A patient is referred for lung function tests on account of a history of breathlessness and cough.

      Which statement about lung volumes is correct?

      Your Answer:

      Correct Answer: The tidal volume is the volume of air drawn in and out of the lungs during normal breathing

      Explanation:

      The tidal volume(TV) is the amount of air that moves in and out of the lungs with each respiratory cycle. In a healthy male, the usual volume is 0.5 L (,7 ml/kg body mass).

      The vital capacity(VC) is the maximum amount of air that can be exhaled following maximal inspiration. The usual volume in a healthy male is 4.5 L.

      The residual volume(RV) is the amount of air remaining in the lungs after maximum expiration. The usual volume in a healthy male is 1.0 L.

      The inspiratory reserve volume(IRV) is the maximum amount of air that can be breathed in forcibly after normal inspiration. The usual volume in a healthy male is 3.0 L.

      The expiratory reserve volume(ERV) is the volume of air that can be breathed out forcibly after normal expiration. The usual volume in a healthy male is 1.0 L.

      Total lung capacity(TLC) is the volume of air the lungs can accommodate. TLC = RV+VC. The usual volume in a healthy male is 5.5 L.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      0
      Seconds
  • Question 22 - A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate,...

    Incorrect

    • A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate, nasal regurgitation of food, and nasal quality to the voice.

      Which of the following cranial nerves is most likely responsible for the aforementioned features?

      Your Answer:

      Correct Answer: Vagus nerve

      Explanation:

      The vagus nerve, ‘the wanderer’, contains motor fibres (to the palate and vocal cords), sensory components (posterior and floor of external acoustic meatus) and visceral afferent and efferent fibres.

      Palatal weakness can cause nasal speech and nasal regurgitation of food. The palate moves asymmetrically when the patient says ‘ahh’. Recurrent nerve palsy results in hoarseness, loss of volume and ‘bovine cough’.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 23 - Regarding alteplase, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding alteplase, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Alteplase is commonly associated with hypotensive effects.

      Explanation:

      Alteplase is a recombinant tissue-type plasminogen activator (tPA), a naturally occurring fibrin-specific enzyme that has selectivity for activation of fibrin-bound plasminogen. It has a short half-life of 3 – 4  minutes and must be given by continuous intravenous infusion but is not associated with antigenic or hypotensive effects, and can be used in patients when recent streptococcal infections or recent use of streptokinase contraindicates the use of streptokinase.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 24 - A 74-year-old woman with a history of ischaemic heart disease and heart failure...

    Incorrect

    • A 74-year-old woman with a history of ischaemic heart disease and heart failure is complaining of worsening oedema, bloating, and a loss of appetite. She has ascites and peripheral oedema on examination. Her oedema is being controlled by an oral diuretic, but it appears that this is no longer enough. You discuss her care with the on-call cardiology registrar, who believes she is very likely to have significant gut oedema that is interfering with her diuretic absorption and that she will need to change her medication.

      Which of the following oral diuretics is most likely to help you overcome this problem?

      Your Answer:

      Correct Answer: Bumetanide

      Explanation:

      Bumetanide is primarily used in patients with heart failure who have failed to respond to high doses of furosemide. Bumetanide and furosemide differ primarily in terms of bioavailability and pharmacodynamic potency. In the intestine, furosemide is only partially absorbed, with a bioavailability of 40-50 percent. Bumetanide, on the other hand, is almost completely absorbed in the intestine and has a bioavailability of about 80%. As a result, when it has a better bioavailability than furosemide, it is commonly used in patients with gut oedema.

      When taken alone, Bendroflumethiazide is a moderately potent diuretic that is unlikely to control her oedema.

      Mannitol is a type of osmotic diuretic used to treat cerebral oedema and high intracranial pressure.

      Acetazolamide is a weak diuretic that inhibits carbonic anhydrase. It’s a rare occurrence.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 25 - All of the following cause bronchoconstriction, EXCEPT for: ...

    Incorrect

    • All of the following cause bronchoconstriction, EXCEPT for:

      Your Answer:

      Correct Answer: Adrenaline

      Explanation:

      Factors causing bronchoconstriction:

      • Via muscarinic receptors
      • Parasympathetic stimulation
      • Stimulation of irritant receptors
      • Inflammatory mediators e.g. histamine, prostaglandins, leukotrienes
      • Beta-blockers

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 26 - Which of the following describes the pulse pressure: ...

    Incorrect

    • Which of the following describes the pulse pressure:

      Your Answer:

      Correct Answer: Systolic - diastolic pressure

      Explanation:

      During systole, the pressure in the left ventricle increases and blood is ejected into the aorta. The rise in pressure stretches the elastic walls of the aorta and large arteries and drives blood flow. Systolic pressure is the maximum arterial pressure during systole. During diastole, arterial blood flow is partly maintained by elastic recoil of the walls of large arteries. The minimum pressure reached before the next systole is the diastolic pressure. The difference between the systolic and diastolic pressure is the pulse pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 27 - What is the mechanism of action of cetirizine: ...

    Incorrect

    • What is the mechanism of action of cetirizine:

      Your Answer:

      Correct Answer: H1-receptor antagonist

      Explanation:

      Cetirizine is a competitive inhibitor at the H1-receptor (an antihistamine).

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      0
      Seconds
  • Question 28 - Regarding the glomerular filtration barrier, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the glomerular filtration barrier, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: The main factor determining whether a substance is filtered or not is molecular weight.

      Explanation:

      Molecular weight is the main factor in determining whether a substance is filtered or not – molecules < 7 kDa in molecular weight are filtered freely e.g. glucose, amino acids, urea, ions but larger molecules are increasingly restricted up to 70 kDa, above which filtration is insignificant. Negatively charged molecules are further restricted, as they are repelled by negative charges, particularly in the basement membrane. Albumin has a molecular weight of 69 kDa and is negatively charged, thus only very small amounts are filtered (and all of the filtered albumin is reabsorbed in the proximal tubule), whereas small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. This means that ultrafiltrate is virtually protein free, but otherwise has an identical composition of that of plasma. The epithelial lining of the Bowman's capsule consists of a single layer of cells called podocytes. The glomerular capillary endothelium is perforated by pores (fenestrations) which allow plasma components with a molecular weight of < 70 kDa to pass freely.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 29 - A 6-year-old girl is brought to the nephrology clinic by her mother due...

    Incorrect

    • A 6-year-old girl is brought to the nephrology clinic by her mother due to facial oedema. Her lab workup shows proteinuria of 7 g/24 hours and serum albumin levels of 15 g/L. A diagnosis of Nephrotic Syndrome is made, and corticosteroid therapy is initiated.

      Which one of the following is the most likely cause of nephrotic syndrome in this patient?

      Your Answer:

      Correct Answer: Minimal change disease

      Explanation:

      Minimal Change Disease is the most common cause of Nephrotic Syndrome in the paediatric population. It may be caused by NSAID use. Electron microscopy shows the fusion of foot processes while light microscopy will appear normal.

      Focal segmental glomerulosclerosis causes Nephrotic Syndrome in adults. It is associated with Heroin use and HIV infection. There is a limited response to steroids, and the disease progresses to end-stage renal failure in 5-10 years.

      Diabetic nephropathy occurs after a long period of diabetes due to the deposition of amyloid protein leading to a decrease in glomerular filtration.

      There is no history of Hepatitis B in this patient and no symptoms of liver disease such as jaundice.

      Membranous glomerulonephritis would present with features of Nephritic Syndrome. These would be oedema, haematuria; red blood cell casts in the urine and hypertension.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
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  • Question 30 - Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is...

    Incorrect

    • Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is responsible for 20% of all leukemias.

      Which of the following statements about CML is NOT TRUE?

      Your Answer:

      Correct Answer: Serum B12 is typically low

      Explanation:

      Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is responsible for 20% of all leukemias. The majority of CML patients experience fatigue, weight loss, and excessive sweating.

      The Philadelphia chromosome is found in over 90% of CML cases. A balanced translocation between chromosomes 9 and 22 is known as the Philadelphia chromosome.

      Because white cells produce a B12 binding protein, serum B12 levels in CML are typically high.

      In CML, the neutrophil alkaline phosphatase score is usually low.

      Almost all patients with CML eventually progress to blast crisis, though this can take up to ten years. If any of the following features are present in a CML patient, a blast crisis is diagnosed:
      In the blood or bone marrow, there are more than 20% myeloblasts or lymphoblasts.
      On a bone marrow biopsy, large clusters of blasts were discovered.

      CML can be treated with tyrosine kinase inhibitors like imatinib and dasatinib if a chloroma (a solid tumour made up of myeloblasts that grows outside of the bone marrow) is present.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Haematology (0/1) 0%
Pathology (0/1) 0%
Passmed