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  • Question 1 - A 55-year-old woman with a known history of bronchiectasis has lung function testing...

    Incorrect

    • A 55-year-old woman with a known history of bronchiectasis has lung function testing carried out and is found to have significant airways obstruction.
      Which of the following lung volumes or capacities is LEAST likely to be decreased in this case? Select ONE answer only.

      Your Answer: Expiratory reserve volume

      Correct Answer: Functional residual capacity

      Explanation:

      Obstructive lung disorders are characterised by airway obstruction. Many obstructive diseases of the lung result from narrowing of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself.
      In obstructive lung disease, FEV1is reduced to <80% of normal and FVC is usually reduced but to a lesser extent than FEV1. The FEV1/FVC ratio is reduced to <0.7.
      Types of obstructive lung disorders include:
      Chronic obstructive pulmonary disease (COPD)
      Asthma
      Bronchiectasis
      The following table outlines the effects of obstructive lung disease on the various lung volumes and capacities:
      Increased by obstructive lung disease
      Decreased in obstructive lung disease
      Total lung capacity (TLC)
      Residual volume (RV)
      Functional residual capacity (FRC) Residual volume/total lung capacity (RV/TLC) ratio
      Vital capacity (VC)
      Inspiratory capacity (IC)
      Inspiratory reserve volume (IRV) Expiratory reserve volume (ERV)
      According to the latestNICE guidelines(link is external), airflow obstruction is defined as follows:
      Mild airflow obstruction = an FEV1of >80% in the presence of symptoms
      Moderate airflow obstruction = FEV1of 50-79%
      Severe airflow obstruction = FEV1of 30-49%
      Very severe airflow obstruction = FEV1<30%.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      16.2
      Seconds

  • Question 2 - At which opioid receptors do opioid analgesics act primarily? ...

    Correct

    • At which opioid receptors do opioid analgesics act primarily?

      Your Answer: Mu

      Explanation:

      Opioid receptors are widely distributed throughout the central nervous system. Opioid analgesics mimic endogenous opioid peptides by causing prolonged activation of these receptors, mainly the mu(μ)-receptors which are the most highly concentrated in brain areas involved in nociception.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      4.1
      Seconds

  • Question 3 - About what percentage of filtered Na+is reabsorbed in the loop of Henle: ...

    Incorrect

    • About what percentage of filtered Na+is reabsorbed in the loop of Henle:

      Your Answer: 15%

      Correct Answer: 25%

      Explanation:

      About 25% of filtered sodium is reabsorbed in the the loop of Henle.

    • This question is part of the following fields:

      • Physiology
      • Renal
      8.7
      Seconds

  • Question 4 - You examine a child who has been admitted to the paediatric emergency department...

    Incorrect

    • You examine a child who has been admitted to the paediatric emergency department with a flu-like illness. His parents tell you that he was born with an inborn defect of steroid metabolism and that he was treated for it with hormone replacement therapy.

      Which of the following is classified as a steroid hormone?

      Your Answer: Noradrenaline

      Correct Answer: Aldosterone

      Explanation:

      Hormones can be classified into three categories depending on their chemical composition: amines, peptides (and proteins), and steroids. Amines are made up of single amino acids (for example, tyrosine), peptide hormones are made up of peptides (or proteins), and steroid hormones are made up of cholesterol.
      The table below lists some prominent instances of each of these three hormone classes:

      1. Peptide hormone:
      Adrenocorticotropic hormone (ACTH)
      Prolactin
      Vasopressin
      Oxytocin
      Glucagon
      Insulin
      Somatostatin
      Cholecystokinin

      2. Amine hormone:
      Adrenaline (epinephrine)
      Noradrenaline (norepinephrine)
      Dopamine

      3. Steroid hormone:
      Mineralocorticoids (e.g. aldosterone)
      Glucocorticoids (e.g. cortisol)
      Progestogens
      Androgens
      Oestrogens

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      15.6
      Seconds

  • Question 5 - The pathophysiology of Addison's disease is as follows: ...

    Correct

    • The pathophysiology of Addison's disease is as follows:

      Your Answer: Adrenocortical insufficiency

      Explanation:

      Primary adrenal insufficiency, also known as Addison’s disease, occurs when the adrenal glands cannot produce an adequate amount of hormones despite a normal or increased corticotropin (ACTH) level.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      11.6
      Seconds

  • Question 6 - After reviewing a child with respiratory distress who presented to the clinic, you...

    Correct

    • After reviewing a child with respiratory distress who presented to the clinic, you make a diagnosis of bronchiolitis.

      What is the most common causative organism?

      Your Answer: Respiratory syncitial virus

      Explanation:

      Bronchiolitis is a common respiratory infection that occurs in infancy between the ages of 3-6 months and in the winter months. It is most commonly caused by the respiratory syncytial virus (70% of cases)

      Although it can also be caused by parainfluenza virus, adenovirus, coronavirus, rhinovirus, and influenza virus, these are not the most common causes

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      12.5
      Seconds

  • Question 7 - Despite taking the oral contraceptive pill, a 29-year-old woman becomes pregnant. During a...

    Correct

    • Despite taking the oral contraceptive pill, a 29-year-old woman becomes pregnant. During a medication review, you discover that she is epileptic and that her antiepileptic therapy has recently been changed.

      Which of the following antiepileptics is most likely to impair the oral contraceptive pill's effectiveness?

      Your Answer: Carbamazepine

      Explanation:

      The metabolism of ethinyl oestradiol and progestogens has been shown to be increased by enzyme-inducing antiepileptics. The oral contraceptive pill (OCP) is less effective in preventing pregnancy as a result of this increased breakdown.

      Antiepileptic drugs that induce enzymes include:
      Carbamazepine
      Phenytoin
      Phenobarbital
      Topiramate

      Antiepileptics that do not induce enzymes are unlikely to affect contraception. Non-enzyme-inducing anticonvulsants include the following:
      Clonazepam
      Gabapentin
      Levetiracetam
      Piracetam
      Sodium valproate is a type of valproate that is used to

      Lamotrigine is an antiepileptic drug that does not cause the production of enzymes. It does, however, require special consideration, unlike other non-enzyme-inducing antiepileptics. The OCP does not appear to affect epilepsy directly, but it does appear to lower lamotrigine levels in the blood. This could result in a loss of seizure control and the occurrence of seizures.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      6.8
      Seconds

  • Question 8 - A 30 year old man presents to ED after a road traffic accident....

    Correct

    • A 30 year old man presents to ED after a road traffic accident. Free intraperitoneal fluid is found on FAST (Focussed assessment for sonography in trauma) done in the supine position.

      Which of these is most likely to be affected?

      Your Answer: Hepatorenal recess

      Explanation:

      Fluid accumulates most often in the hepatorenal pouch (of Morrison) in a supine patient. The hepatorenal pouch is located behind the liver and anterior to the right kidney and is the lowest space in the peritoneal cavity in the supine position.

      Although the vesicouterine and rectouterine spaces are also potential spaces for fluid accumulation, fluid accumulation in them occur in the erect position.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      47.5
      Seconds

  • Question 9 - The functional residual capacity (FRC) will be increased in which of the following:...

    Correct

    • The functional residual capacity (FRC) will be increased in which of the following:

      Your Answer: Emphysema

      Explanation:

      Factors increasing FRC:
      Emphysema
      Air trapping in asthma
      Ageing (due to loss of elastic properties)
      Increasing height of patient

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      4.7
      Seconds

  • Question 10 - A 56-year-old female presents at the hospital with a diabetic foot ulcer that...

    Correct

    • A 56-year-old female presents at the hospital with a diabetic foot ulcer that has become infected. She has a longstanding history of type 2 diabetes mellitus and diabetic polyneuropathy. She has trouble controlling her blood sugar levels, and recently, she was converted to a new insulin regimen that includes intermediate-acting insulin.

      Out of the following, which one is the intermediate-acting insulin?

      Your Answer: Isophane insulin

      Explanation:

      Insulin is used mainly in type 1 diabetes, where the pancreas makes no insulin and can sometimes be prescribed in type 1 diabetes. There are different types of insulin categorized by their onset of action:

      1. Intermediate-acting insulins (isophane insulin NPH):
      – intermediate duration of action, designed to mimic the effect of endogenous basal insulin
      – starts their action in 1 to 4 hours
      – peaks in 4 to 8 hours
      – dosing is usually twice a day and helps maintain blood sugar throughout the day
      – Isophane insulin is a suspension of insulin with protamine

      2. Short-acting insulins (regular insulin)
      – starts the action in 30 to 40 minutes
      – peaks in 90 to 120 minutes
      – duration of action is 6 to 8 hours
      – taken before meals, and food is necessary within 30 minutes after its administration to avoid hypoglycaemia

      3. Long-acting insulins (glargine, detemir, degludec)
      – start action in 1 to 2 hours
      – plateau effect over 12 to 24 hours
      – Dosing is usually during the night-time after meals. Their long duration of action helps in reducing the frequency of dosing throughout the day.

      4. Rapid-acting insulins (lispro, aspart, glulisine)
      – start their action in 5 to 15 minutes
      – peak in 30 minutes
      – The duration of action is 3 to 5 hours
      – generally used before meals and always used along with short-acting or long-acting insulins to control sugar levels throughout the day.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      21.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Physiology (2/5) 40%
Respiratory Physiology (0/1) 0%
Central Nervous System (1/1) 100%
Pharmacology (3/3) 100%
Renal (0/1) 0%
Endocrine Physiology (0/1) 0%
Endocrine (1/1) 100%
Microbiology (1/1) 100%
Specific Pathogen Groups (1/1) 100%
CNS Pharmacology (1/1) 100%
Abdomen (1/1) 100%
Anatomy (1/1) 100%
Respiratory (1/1) 100%
Endocrine Pharmacology (1/1) 100%
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