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  • Question 1 - Regarding hypernatraemia, which of the following statements is INCORRECT: ...

    Correct

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

      Your Answer: In acute severe hypernatraemia, seizures and intracranial vascular haemorrhage can occur as a result of brain cell lysis.

      Explanation:

      Acute severe hypernatraemia is a medical emergency and requires inpatient management in a high dependency setting. Seizures and intracranial vascular haemorrhage as a result of brain cell crenation can occur. The cause is most commonly excessive water loss and the key aspect of treatment is aggressive fluid replacement (typically with normal saline as this is relatively hypotonic). If urine osmolality is low, diabetes insipidus (DI )should be considered and a trial of synthetic ADH given. In patients with known DI, it is essential to ensure synthetic ADH is given parenterally and that close fluid balance is observed.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      84.7
      Seconds

  • Question 2 - Superficial fibular nerve palsy results in which of the following clinical features: ...

    Incorrect

    • Superficial fibular nerve palsy results in which of the following clinical features:

      Your Answer: Loss of dorsiflexion of the foot

      Correct Answer: Loss of eversion of the foot

      Explanation:

      Damage to the superficial fibular nerve results in loss of eversion of the foot and loss of sensation over the lower anterolateral leg and the dorsum of the foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      27.8
      Seconds

  • Question 3 - Which of the following statements concerning hepatitis D is TRUE: ...

    Incorrect

    • Which of the following statements concerning hepatitis D is TRUE:

      Your Answer: Hepatitis D is actually protective against hepatocellular carcinoma.

      Correct Answer: It can only be transmitted with, or to somebody who is infected with, Hepatitis B.

      Explanation:

      Hepatitis D virus (HDV) is an RNA virus that was discovered in 1977 and is structurally unrelated to the hepatitis A (HAV), hepatitis B (HBV), and hepatitis C (HCV) viruses. HDV causes a unique infection that requires the assistance of HBV viral particles to replicate and infect hepatocytes. Its clinical course is varied and ranges from acute, self-limited infection to acute, fulminant liver failure. Chronic liver infection can lead to end-stage liver disease and associated complications (including accelerated fibrosis, liver decompensation, and hepatocellular carcinoma).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      38.8
      Seconds

  • Question 4 - A 69-year-old man presents with a painful groin swelling on the right side....

    Correct

    • A 69-year-old man presents with a painful groin swelling on the right side. The suspected diagnosis is an inguinal hernia.

      Which of the following examination features make it more likely to be an indirect inguinal hernia?

      Your Answer: It can be controlled by pressure over the deep inguinal ring

      Explanation:

      The reduced indirect inguinal hernia can be controlled by pressure over the internal ring; a direct inguinal hernia cannot.

      An indirect inguinal hernia can be reduced superiorly then superolaterally, while a direct inguinal hernia can be reduced superiorly then posteriorly.

      An indirect inguinal hernia takes time to reach full size, but a direct inguinal hernia appears immediately upon standing.

      Indirect inguinal hernias are seen as elliptical swelling, while direct inguinal hernias appear as symmetric, circular swelling.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      46.3
      Seconds

  • Question 5 - A young female was diagnosed with a urinary tract infection and was sent...

    Incorrect

    • A young female was diagnosed with a urinary tract infection and was sent home with medications. However, after 48 hours of discharge, she returned to the hospital because there had been no relief from her symptoms. The urine sensitivity test report is still unavailable. Fresh blood tests were sent, and her estimated GFR is calculated to be >60 ml/minute.

      She was prescribed nitrofurantoin 100 mg modified-release orally twice a day for two days.

      Out of the following, which antibiotic is most appropriate to be prescribed to this patient?

      Your Answer: Ciprofloxacin

      Correct Answer: Fosfomycin

      Explanation:

      The NICE guidelines for women with lower UTIs who are not pregnant are:
      1. Consider prescribing a different antibiotic if symptoms do not improve within 48 hours or worsen at any time
      2. If the urine culture and susceptibility test results are available, review the choice of antibiotic according to the results and change the antibiotic accordingly if symptoms are not improving or bacteria is resistant to the prescribed antibiotic

      The first choice of antibiotics for non-pregnant women aged 16 years and over is:
      1. Nitrofurantoin
      100 mg modified-release PO BD for 3 days – if eGFR >45 ml/minute
      2. Trimethoprim
      200 mg PO BD for three days

      The second-choice (no improvement in lower UTI symptoms on first-choice for at least 48 hours, or when first-choice is not suitable) are:
      1. Nitrofurantoin
      100 mg modified-release PO BD for three days – if eGFR >45 ml/minute
      2. Pivmecillinam
      400 mg PO initial dose, then 200 mg PO TDS for three days
      3. Fosfomycin 3 g single sachet dose

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      49.1
      Seconds

  • Question 6 - A 28 year old man presents with abdominal pain and constipation, and bloods...

    Correct

    • A 28 year old man presents with abdominal pain and constipation, and bloods show hypocalcaemia. Which of the following hormones is increased as a result of hypocalcaemia?

      Your Answer: Parathyroid hormone

      Explanation:

      Parathyroid hormone (PTH), also called parathormone or parathyrin, is a peptide hormone that is secreted by the parathyroid glands, which lie immediately behind the thyroid gland. In particular, this hormone is made by chief cells. It regulates the serum calcium concentration through its effects on bone, kidney, and intestine. This hormone is primarily released in response to decreasing plasma Ca2+ concentration and it serves to increase plasma calcium levels and decrease plasma phosphate levels.
      PTH activates Ca2+entry channels in the apical membrane and the Ca2+ATPase pump in the basolateral membrane and as a result, increases calcium reabsorption in the distal tubule of the nephron. It inhibits reabsorption of phosphate and this increases its excretion by in the proximal tubule of the nephron.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      28
      Seconds

  • Question 7 - Regarding fat digestion, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding fat digestion, which of the following statements is CORRECT:

      Your Answer: Bile acids emulsify triglycerides into monoglycerides and fatty acids.

      Correct Answer: Lipids are reesterified in the smooth endoplasmic reticulum of the enterocyte.

      Explanation:

      Fats are digested almost entirely in the small intestine and are only released from the stomach into the duodenum at the rate at which they can be digested (the presence of fatty acids and monoglycerides in the duodenum inhibits gastric emptying). In the duodenum fat is emulsified by bile acids, a process where larger lipid droplets are broken down into much smaller droplets providing a greater surface area for enzymatic digestion. Pancreatic lipase digests triglyceride into monoglycerides and free fatty acids. The products of fat digestion (fatty acids and monoglycerides), cholesterol and fat-soluble vitamins diffuse passively into the enterocytes. Once inside the epithelial cell, lipid is taken into the smooth endoplasmic reticulum where much of it is re esterified. Dietary and synthesised lipids are then incorporated into chylomicrons in the Golgi body, which are exocytosed from the basolateral membrane to enter lacteals.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      51.8
      Seconds

  • Question 8 - Foetal haemoglobin (HbF) comprises about how much of the total haemoglobin in adults:...

    Incorrect

    • Foetal haemoglobin (HbF) comprises about how much of the total haemoglobin in adults:

      Your Answer: 0.01

      Correct Answer: 0.5 - 0.8%

      Explanation:

      Foetal haemoglobin (HbF) makes up about 0.5 – 0.8 % of total adult haemoglobin and consists of two α and two gamma (γ) globin chains.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      13.3
      Seconds

  • Question 9 - Which of the following ABO blood groups is the universal recipient: ...

    Correct

    • Which of the following ABO blood groups is the universal recipient:

      Your Answer: AB

      Explanation:

      Blood group AB has both A and B antigens but no antibodies and thus is the universal recipient.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      7.2
      Seconds

  • Question 10 - What is the correct adrenaline dose for a patient with pulseless ventricular tachycardia?...

    Incorrect

    • What is the correct adrenaline dose for a patient with pulseless ventricular tachycardia?

      Your Answer: 0.5 ml of 1 in 1000 adrenaline solution

      Correct Answer: 10 ml of 1 in 10,000 adrenaline solution

      Explanation:

      Ventricular fibrillation or pulseless ventricular tachycardia (VF/VT) are referred to as shockable rhythm.

      IV adrenaline 1 mg (10 mL of 1:10,000 solution) should be administered after 3 shocks and every 3 – 5 minutes/after alternate shocks thereafter for a shockable rhythm.

      For a non-shockable rhythm, 1 mg IV adrenaline should be administered as soon as IV access is obtained, and then every 3 – 5 minutes/after alternate shocks thereafter.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      34.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrine (2/2) 100%
Physiology (2/4) 50%
Anatomy (1/2) 50%
Lower Limb (0/1) 0%
Microbiology (0/1) 0%
Pathogens (0/1) 0%
Abdomen And Pelvis (1/1) 100%
Infections (0/1) 0%
Pharmacology (0/2) 0%
Gastrointestinal (0/1) 0%
Basic Cellular (0/1) 0%
Immune Responses (1/1) 100%
Pathology (1/1) 100%
Cardiovascular (0/1) 0%
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