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Question 1
Correct
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A patient is admitted to the ICU, and is prescribed tazobactam, amongst other drugs. What is the mechanism of action of tazobactam?
Your Answer: Inhibits beta-lactamase
Explanation:Tazobactam is a compound which inhibits the action of bacterial beta-lactamases. It is added to the extended-spectrum beta-lactam antibiotic piperacillin to broaden the spectrum of piperacillin by making it effective against organisms that express beta-lactamase and would normally degrade piperacillin.
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This question is part of the following fields:
- Pathology
- Pharmacology
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Question 2
Incorrect
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A man had an injury to his right brachial plexus. After examination by the doctor they found that the diaphragm and the scapula were unaffected however the patient could not abduct his arm. When helped with abducting his arm to 45 degrees he was able to continue the movement. This means that he was unable to initiate abduction. Where is the likely site of injury?
Your Answer: Roots of the plexus
Correct Answer: Suprascapular nerve
Explanation:The loss of ability to initiate abduction means paralysis of the supraspinatus muscle. This muscle is supplied by the supraclavicular nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 3
Correct
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Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be seen in:
Your Answer: Cerebellar disease
Explanation:The given symptoms are seen in diseases affecting the cerebellum. A cerebellar tremor is a slow tremor that occurs at the end of a purposeful movement. It is seen in cerebellar disease, such as multiple sclerosis or some inherited degenerative disorders and chronic alcoholism. Classically, tremors are produced in the same side of the body as a one-sided lesion. Cerebellar disease can also result in a wing-beating’ type of tremor called rubral or Holmes’ tremor – a combination of rest, action and postural tremors. Other signs of cerebellar disease include dysarthria (speech problems), nystagmus (rapid, involuntary rolling of the eyes), gait problems and postural tremor of the trunk and neck.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 4
Correct
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A 65-year-old man complains of headaches, weakness, cramps, and confusion; blood tests reveal he has severe hyponatremia. The most likely cause is:
Your Answer: Severe diarrhoea or vomiting
Explanation:Hyponatraemia occurs when the sodium level in the plasma falls below 135 mmol/l. Hyponatraemia is an abnormality that can occur in isolation or, more commonly as a complication of other medical illnesses. Severe hyponatraemia may cause osmotic shift of water from the plasma into the brain cells. Typical symptoms include nausea, vomiting, headache and malaise. As the hyponatraemia worsens, confusion, diminished reflexes, convulsions, stupor or coma may occur. The cause of hyponatremia is typically classified by a person’s fluid status into low volume, normal volume, and high volume. Low volume hyponatremia can occur from diarrhoea, vomiting, diuretics, and sweating.
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This question is part of the following fields:
- Fluids & Electrolytes
- Physiology
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Question 5
Correct
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A patient under went repair of a lingual artery aneurysm in the floor of the mouth. During surgical dissection from the inside of the mouth which muscle would you have to pass through to reach the main portion of the lingual artery?
Your Answer: Hyoglossus
Explanation:The lingual artery first runs obliquely upward and medialward to the greater horns of the hyoid bone. It then curves downward and forward, forming a loop which is crossed by the hypoglossal nerve, and passing beneath the digastric muscle and stylohyoid muscle it runs horizontally forward, beneath the hyoglossus, and finally, ascending almost perpendicularly to the tongue, turns forward on its lower surface as far as the tip, to become the deep lingual artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 6
Incorrect
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Renin is secreted by pericytes in the vicinity of the afferent arterioles of the kidney from the juxtaglomerular cells. Plasma renin levels are decreased in patients with:
Your Answer: Renal artery stenosis
Correct Answer: Primary aldosteronism
Explanation:Primary aldosteronism, also known as primary hyperaldosteronism or Conn’s syndrome, is excess production of the hormone aldosterone by the adrenal glands resulting in low renin levels. Most patients with primary aldosteronism (Conn’s syndrome) have an adrenal adenoma. The increased plasma aldosterone concentration leads to increased renal Na+ reabsorption, which results in plasma volume expansion. The increase in plasma volume suppresses renin release from the juxtaglomerular apparatus and these patients usually have low plasma renin levels. Salt restriction and upright posture decrease renal perfusion pressure and therefore increases renin release from the juxtaglomerular apparatus. Secondary aldosteronism is due to elevated renin levels and may be caused by heart failure or renal artery stenosis.
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This question is part of the following fields:
- Physiology
- Renal
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Question 7
Correct
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A 38 year old man is to undergo excision of the base of the prostate for malignant growth, which of the following structures is directly related to the base of the prostate?
Your Answer: Urinary bladder
Explanation:The prostate is situated in the pelvic cavity and is also located immediately below the internal urethral orifice at the commencement of the urethra. It is held in position by the puboprostatic ligaments, the superior fascia of the urogenital diaphragm and the anterior portions of the levatores ani. The base of the prostate is directed upward and is attached to the inferior surface of the urinary bladder while the apex is directed downward and is in contact with the superior fascia of the urogenital diaphragm.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 8
Correct
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Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?
Your Answer: Anterior talofibular ligament
Explanation:The anterior talofibular ligament passes from the anterior margin of the fibular malleolus. It is the most commonly injured ligament, as part of the lateral ligament of the ankle.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 9
Correct
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A 55-years-old man presented to the emergency department complaining of a squeezing sensation in his chest that has spread to his neck with associated worsening shortness of breath. Which of these laboratory tests would you ask for in this patient:
Your Answer: Creatine kinase-MB
Explanation:Creatine kinase-MB is a test that usually is ordered when the patient has chest pain as a cardiac marker. When a heart attack is suspected and a troponin test (which is more specific for heart damage), is not available CK-MB is ordered. There are 3 forms of CK: CK-MM, CK-BB and CK-MB. CK-MB is commonly found in heart tissue, therefore injured heart muscle cells release CK-MB into the blood. Elevated CK-MB levels indicate that it is probable that a person has recently had a heart attack.
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This question is part of the following fields:
- Cardiovascular
- Pathology
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Question 10
Incorrect
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A 5-year-old child is rushed to the emergency department because of fever, erythema and neck stiffness. The child is also hypotensive upon physical examination. Which is the most likely toxin responsible for this child's condition?
Your Answer: Exotoxin
Correct Answer: Endotoxin
Explanation:An endotoxin is part of the bacterial outer membrane, and it is not released until the bacterium is killed by the immune system. The body’s response to an endotoxin can involve severe inflammation. In general, the inflammation process is usually considered beneficial to the infected host, but if the reaction is severe enough, it can lead to sepsis.
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This question is part of the following fields:
- Microbiology
- Pathology
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