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  • Question 1 - A patient suffered from a chest injury while working out in the gym....

    Incorrect

    • A patient suffered from a chest injury while working out in the gym. As a consequence of his injury, his pectoralis minor muscle was damaged.

      Which of the following statements regarding the pectoralis minor muscle is considered correct?

      Your Answer: It flexes the humerus

      Correct Answer: It stabilises the scapula

      Explanation:

      The pectoralis minor, in comparison to the pectoralis major, is much thinner and triangular in shape and resides below the major. It originates from the margins of the third to fifth ribs adjacent to the costochondral junction. The fibres consequently pass upward and laterally to insert into the medial border and superior surface of the coracoid process. It is crucial in the stabilization of the scapula by pulling it downward and anteriorly against the thoracic wall.

      Arterial supply to the pectoralis minor also derives from the pectoral branch of the thoracoacromial trunk. Nerve supply of the pectoralis minor is a function of the lateral pectoral nerve and the medial pectoral nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      653.8
      Seconds
  • Question 2 - Which statement about cross-sectional studies is true? ...

    Incorrect

    • Which statement about cross-sectional studies is true?

      Your Answer: They are suitable for the study of rare diseases

      Correct Answer: They can be used to assess the prevalence of a condition

      Explanation:

      Cross-sectional studies can be used to assess the prevalence of a condition.

      Cross-sectional studies CANNOT be used to differentiate between cause and effect or establish the sequence of events.

      They can be used to study multiple outcomes but are NOT suitable for studying rare diseases.

    • This question is part of the following fields:

      • Evidence Based Medicine
      21
      Seconds
  • Question 3 - Regarding ACE inhibitors, which of the following statements is CORRECT: ...

    Correct

    • Regarding ACE inhibitors, which of the following statements is CORRECT:

      Your Answer: Angiotensin-II receptor blockers are a useful alternative in patients who cannot tolerate ACE-inhibitors due a persistent cough.

      Explanation:

      ACE inhibitors should be used with caution in patients of Afro-Caribbean descent who may respond less well; calcium channel blockers are first line for hypertension in these patients. ACE inhibitors have a role in the management of diabetic nephropathy. ACE inhibitors are contraindicated in pregnant women. ACE inhibitors inhibit the breakdown of bradykinin; this is the cause of the persistent dry cough. Blocking ACE also diminishes the breakdown of the potent vasodilator bradykinin which is the cause of the persistent dry cough. Angiotensin-II receptor blockers do not have this effect, therefore they are useful alternative for patients who have to discontinue an ACE inhibitor because of persistent cough.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      22.2
      Seconds
  • Question 4 - A 30-year-old man present to the ED with abdominal pain, nausea and vomiting....

    Correct

    • A 30-year-old man present to the ED with abdominal pain, nausea and vomiting. It has been present for the past two days.

      Which of the following statements regarding diarrhoea and vomiting is true?

      Your Answer: E.Coli can cause diarrhoea and renal failure

      Explanation:

      Escherichia coli strain 0157 causes enterohaemorrhagic diarrhoea and can lead to renal failure, haemolytic anaemia and thrombocytopenia.

      Norwalk virus is an RNA virus.

      Although transmission of rotavirus is primarily through the faeco-oral route, airborne spread has been seen in some cases.

      Cryptosporidium are protozoa with acid fast walls and are resistant to both chlorine treatment and conventional filtering methods.

      There is no therapy effective in treating cryptosporidium diarrhoea as the protozoa is not susceptible to antibiotics.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      28.1
      Seconds
  • Question 5 - Which of the following is NOT a typical side effect of opioid analgesics:...

    Correct

    • Which of the following is NOT a typical side effect of opioid analgesics:

      Your Answer: Diarrhoea

      Explanation:

      All opioids have the potential to cause:
      Gastrointestinal effects – Nausea, vomiting, constipation, difficulty with micturition (urinary retention), biliary spasm
      Central nervous system effects – Sedation, euphoria, respiratory depression, miosis
      Cardiovascular effects – Peripheral vasodilation, postural hypotension
      Dependence and tolerance

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      18.7
      Seconds
  • Question 6 - A 40-year-old woman presents with retrosternal central chest pain that she has been...

    Correct

    • A 40-year-old woman presents with retrosternal central chest pain that she has been complaining about for the past two days. Upon deep inspiration and while lying flat, the pain worsens but relieved by sitting forwards. The pain radiates to both of her shoulders. The result of her ECG shows widespread concave ST-elevation and PR depression. A diagnosis of pericarditis is suspected.

      Which of the following nerves is responsible for the pattern of her pain?

      Your Answer: Phrenic nerve

      Explanation:

      Pericarditis is inflammation of the pericardial sac and is the most common pathologic process involving the pericardium. Frequently, pericardial inflammation can be accompanied by increased fluid accumulation within the pericardial sac forming a pericardial effusion, which may be serous, hemorrhagic or purulent depending on aetiology.

      The classic presentation is with chest pain that is central, severe, pleuritic (worse on deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      38.5
      Seconds
  • Question 7 - Insulin binds to the insulin receptor (IR) on cell surfaces to exert its...

    Correct

    • Insulin binds to the insulin receptor (IR) on cell surfaces to exert its action. The IR is a very specific transmembrane receptor belonging to the tyrosine kinase receptor class.

      One of these also activates the IR:

      Your Answer: IGF-I

      Explanation:

      Insulin receptor (IR), in addition to being activated by insulin, is also activated by IGF-I and IGF-II.

      The IR is a dimer with two identical subunits spanning the cell membrane and are connected by a single disulphide bond. The two sub-units include: The alpha chain situated on the exterior of the cell membrane and the beta chain spanning the cell membrane in a single segment.

      When insulin is detected, the alpha chains move together folding around the insulin making the beta chains move together, converting them into an active tyrosine kinase. This initiates a phosphorylation cascade increasing the expression of GLUT4 and allowing uptake of glucose by cells.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      11.6
      Seconds
  • Question 8 - Which of the following laboratory findings is NOT typical of von Willebrand disease...

    Correct

    • Which of the following laboratory findings is NOT typical of von Willebrand disease (VWD):

      Your Answer: Thrombocytopaenia

      Explanation:

      Laboratory findings typically show (although this varies depending on VWD type):
      Abnormal PFA-100 test
      Low factor VIII levels (if low a factor VIII/VWF binding assay is performed)
      Prolonged APTT (or normal)
      Normal PT
      Low VWF levels
      Defective platelet aggregation
      Normal platelet count

    • This question is part of the following fields:

      • Haematology
      • Pathology
      18
      Seconds
  • Question 9 - Which of the following statements is incorrect regarding potassium replacement? ...

    Correct

    • Which of the following statements is incorrect regarding potassium replacement?

      Your Answer: Oral potassium supplements are often required for patients taking spironolactone.

      Explanation:

      It is very seldom that potassium supplements are required with the small doses of diuretics given to treat hypertension. Potassium-sparing diuretics like spironolactone (rather than potassium supplements), are recommended for hypokalaemia prevention when diuretics are given to eliminate oedema, such as furosemide or the thiazides.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      34.4
      Seconds
  • Question 10 - Regarding penicillin antibiotics, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding penicillin antibiotics, which of the following statements is CORRECT:

      Your Answer: Patients who only develop a rash or urticaria immediately after penicillin should not be noted as having a penicillin allergy.

      Correct Answer: Patients with a history of atopy are at higher risk of hypersensitivity reactions.

      Explanation:

      Allergic reactions to penicillins occur in 1 – 10% of exposed individuals; anaphylactic reactions occur in fewer than 0.05% of treated patients. Patients with a history of atopic allergy are at higher risk of anaphylactic reactions to penicillins. Patients with a history of anaphylaxis, urticaria, or rash immediately after penicillin use should not receive a penicillin or other beta-lactam antibiotics; about 0.5 – 6.5 % of penicillin-sensitive patients will also be allergic to the cephalosporins.

      Patients with a history of a more minor rash (i.e. non-confluent, non-pruritic rash restricted to a small area of the body) or delayed reaction (rash occurring more than 72 hours after penicillin administration), may not be truly allergic and may be considered for penicillin or beta-lactam treatment in severe infection (although possibility of allergy should be borne in mind). Other beta-lactam antibiotics (including cephalosporins) can be used in these patients.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      173.6
      Seconds
  • Question 11 - When there is the presence of distended and engorged veins in the umbilical...

    Correct

    • When there is the presence of distended and engorged veins in the umbilical area, which of the following portosystemic anastomoses has most likely occurred?

      Your Answer: Para-umbilical veins and inferior epigastric vein

      Explanation:

      Caput medusae is a condition that consists of collateral veins radiating from the umbilicus and results from recanalization of the umbilical vein.

      Under normal conditions, the portal venous blood traverses the liver and drains into the inferior vena cava of the systemic venous circulation by way of the hepatic veins. This is the direct route. However, other, smaller communications exist between the portal and systemic systems, and they become important when the direct route becomes blocked. These communications are as follows:

      At the lower third of the oesophagus, the oesophageal branches of the left gastric vein (portal tributary) anastomose with the oesophageal veins draining the middle third of the oesophagus into the azygos veins (systemic tributary).

      Halfway down the anal canal, the superior rectal veins (portal tributary) draining the upper half of the anal canal anastomosis with the middle and inferior rectal veins (systemic tributaries), which are tributaries of the internal iliac and internal pudendal veins, respectively.

      The paraumbilical veins connect the left branch of the portal vein with the superficial veins of the anterior abdominal wall (systemic tributaries). The paraumbilical veins travel in the falciform ligament and accompany the ligamentum teres.

      The veins of the ascending colon, descending colon, duodenum, pancreas, and liver (portal tributary) anastomose with the renal, lumbar, and phrenic veins (systemic tributaries).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      14.3
      Seconds
  • Question 12 - The action potential is generated by excitable tissues, which are specialized tissues that...

    Correct

    • The action potential is generated by excitable tissues, which are specialized tissues that can generate a meaningful electrical signal. Local currents transport action potentials down the axons of neurons.

      Which of the following claims about the action potential's conduction is correct?

      Your Answer: The areas of the membrane that have recently depolarised will not depolarise again due to the refractory period

      Explanation:

      Local currents propagate action potentials down the axons of neurons. Following depolarization, this local current flow depolarizes the next axonal membrane, and when this region crosses the threshold, more action potentials are formed, and so on. Due to the refractory period, portions of the membrane that have recently depolarized will not depolarize again, resulting in the action potential only being able to go in one direction.

      The square root of axonal diameter determines the velocity of the action potential; the axons with the biggest diameter have the quickest conduction velocities. When a neuron is myelinated, the speed of the action potential rises as well.

      The myelin sheath is an insulating coating that surrounds certain neural axons. By increasing membrane resistance and decreasing membrane capacitance, the myelin coating increases conduction. This enables faster electrical signal transmission via a neuron, making them more energy-efficient than non-myelinated neuronal axons.

      Nodes of Ranvier are periodic holes in a myelinate axon when there is no myelin and the axonal membrane is exposed. There are no gated ion channels in the portion of the axon covered by the myelin sheath, but there is a high density of ion channels in the Nodes of Ranvier. Action potentials can only arise at the nodes as a result of this.
      Electrical impulses are quickly transmitted from one node to the next, causing depolarization of the membrane above the threshold and triggering another action potential, which is then transmitted to the next node. An action potential is rapidly conducted down a neuron in this manner. Saltatory conduction is the term for this.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      1306.9
      Seconds
  • Question 13 - A newborn baby is referred by the community midwife who is concerned the...

    Correct

    • A newborn baby is referred by the community midwife who is concerned the baby is jaundiced because of the yellow appearance of his eyes and skin following a postnatal home visit. The jaundice is visible in the baby’s feet making her worried.

      Jaundice are visible in the extremities of neonates at what approximate threshold bilirubin level?

      Your Answer: 255 μmol/L

      Explanation:

      Newborn babies have a higher concentration of red blood cells with shorter lifespan leading to higher bilirubin levels than in adults. This condition is short-lived and harmless but with potential serious causes that need to be assessed for if present.

      The most obvious physical sign of jaundice is a yellow discolouration of the sclera, skin and mucous membranes. At a bilirubin level of 35 μmol/L or higher, the eye is affected. The bilirubin level will need to be higher than 255 μmol/L for the feet and extremities to be affected.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      18.8
      Seconds
  • Question 14 - An ambulance transports a 37-year-old woman who is having a seizure. She is...

    Correct

    • An ambulance transports a 37-year-old woman who is having a seizure. She is moved to resuscitation and given a benzodiazepine dose, which quickly ends the seizure. You later learn that she has epilepsy and is usually treated with carbamazepine to control her seizures.

      What is carbamazepine's main mechanism of action?

      Your Answer: Sodium channel blocker

      Explanation:

      Carbamazepine is primarily used to treat epilepsy, and it is effective for both focal and generalised seizures. It is not, however, effective in the treatment of absence or myoclonic seizures. It’s also commonly used to treat neuropathic pain, as well as a second-line treatment for bipolar disorder and as a supplement for acute alcohol withdrawal.

      Carbamazepine works as a sodium channel blocker that preferentially binds to voltage-gated sodium channels in their inactive state. This prevents an action potential from firing repeatedly and continuously.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      669.1
      Seconds
  • Question 15 - You are calculating the anion gap on a patient with an acid-base disturbance...

    Correct

    • You are calculating the anion gap on a patient with an acid-base disturbance and you find the anion gap to be low. Which of the following is the most likely cause for the low anion gap:

      Your Answer: Hypoalbuminaemia

      Explanation:

      A low anion gap is frequently caused by hypoalbuminemia. Albumin is a negatively charged protein and its loss from the serum results in the retention of other negatively charged ions such as chloride and bicarbonate. As bicarbonate and chloride anions are used to calculate the anion gap, there is a subsequent decrease in the gap. The anion gap is sometimes reduced in multiple myeloma, where there is an increase in plasma IgG (paraproteinaemia).

    • This question is part of the following fields:

      • Physiology
      • Renal
      49.5
      Seconds
  • Question 16 - Which of the following statements is correct with regards to immunoglobulin? ...

    Correct

    • Which of the following statements is correct with regards to immunoglobulin?

      Your Answer: The isotype of immunoglobulin is determined by the heavy chain.

      Explanation:

      The composition of immunoglobulin molecules is two identical heavy and two identical light chains. These chains are linked by disulphide bridges and are each have highly variable regions which give the immunoglobulin its specificity. In addition, they have constant regions and there is virtual complete correspondence in amino acid sequence in all antibodies of a given isotype.
      Five isotypes of immunoglobulin exist – these are IgG, IgA, IgM, IgE and IgD. They are determined by the heavy chain (gamma, alpha, mu, epsilon or delta respectively). The light chains are either kappa or lambda.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      37.5
      Seconds
  • Question 17 - A 6 year old boy is brought into the ED by his mom...

    Correct

    • A 6 year old boy is brought into the ED by his mom with a rash that is associated with Koplik's spots and a diagnosis of measles is made. What advice should be given about returning to school?

      Your Answer: 4 days from the onset of the rash

      Explanation:

      Prevention of spread of measles is extremely important and infected patients should be isolated. The infectious stage is from 3 days before the rash emerges and patients are advised to stay away from school/nursery/work for 4 days from onset of the rash.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      41.1
      Seconds
  • Question 18 - Regarding the lacrimal apparatus, which of the following statements is CORRECT: ...

    Correct

    • Regarding the lacrimal apparatus, which of the following statements is CORRECT:

      Your Answer: Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

      Explanation:

      Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      23.7
      Seconds
  • Question 19 - Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic...

    Correct

    • Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels. The phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.

      A phenylalkylamine calcium-channel blocker is, for example, which of the following?

      Your Answer: Verapamil

      Explanation:

      Calcium-channel blockers, also known as calcium antagonists, stop calcium from entering cells through the L-type calcium channel. This causes vascular smooth muscle in vessel walls to relax, resulting in a decrease in peripheral vascular resistance.
      They can be used for a variety of things, including:
      Hypertension
      Angina
      Atrial fibrillation
      Migraine

      Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels.

      Dihydropyridines have a high vascular selectivity and lower systemic vascular resistance and blood pressure. As a result, they’re frequently used to treat hypertension. Modified release formulations are also used to treat angina, but their powerful systemic vasodilator and pressure-lowering effects can cause reflex cardiac stimulation, resulting in increased inotropy and tachycardia, which can counteract the beneficial effects of reduced afterload on myocardial oxygen demand.

      The suffix -dpine distinguishes dihydropyridines from other pyridines. Examples of dihydropyridines that are commonly prescribed include:
      Amlodipine
      Felodipine
      Nifedipine
      Nimodipine

      The phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.

      Phenylalkylamines are less effective as systemic vasodilators because they are relatively selective for the myocardium. This group of drugs lowers myocardial oxygen demand and reverses coronary vasospasm, making them useful in the treatment of angina. They are also occasionally used to treat arrhythmias. A phenylalkylamine calcium-channel blocker like verapamil is an example.

      In terms of selectivity for vascular calcium channels, benzothiazepines fall somewhere between dihydropyridines and phenylalkylamines. They can lower arterial pressure without producing the same level of reflex cardiac stimulation as dihydropyridines because they have both cardiac depressant and vasodilator effects. Diltiazem is the only benzothiazepine currently in clinical use.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      9.3
      Seconds
  • Question 20 - You are asked to review the blood results on a 56-year-old man who...

    Incorrect

    • You are asked to review the blood results on a 56-year-old man who appears to be acutely unwell. His results show that he is neutropenic.
      Which ONE of the following is NOT a recognized cause of a neutropenia?

      Your Answer: Viral infections

      Correct Answer: Hyposplenism

      Explanation:

      Neutropenia is defined as a total neutrophil count of < 2.0 x 109/l.
      It can be caused by:
      Viral infections
      Collagen disease e.g. SLE and RA
      Chemotherapy and radiotherapy
      Hypersplenism
      Marrow infiltration
      Vitamin and folate deficiency
      Drug reactions
      Drugs that cause neutropenia include flecainide, phenytoin, carbimazole, indomethacin and co-trimoxazole.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      28.2
      Seconds
  • Question 21 - A 71-year-old woman presents with complaints of fatigue and worsening muscle weakness, and...

    Incorrect

    • A 71-year-old woman presents with complaints of fatigue and worsening muscle weakness, and blood tests done shows a potassium level of 2.4 mmol/L.

      Which is NOT a recognised cause of hypokalaemia?

      Your Answer: Type 1 renal tubular acidosis

      Correct Answer: Type 4 renal tubular acidosis

      Explanation:

      A plasma potassium less than 3.5 mmol/L defines hypokalaemia.

      Excessive liquorice ingestion causes hypermineralocorticoidism and leads to hypokalaemia.

      Gitelman’s syndrome causes metabolic alkalosis with hypokalaemia and hypomagnesaemia. It is an inherited defect of the distal convoluted tubules.

      Bartter’s syndrome causes hypokalaemic alkalosis. It is a rare inherited defect in the ascending limb of the loop of Henle.

      Type 1 and 2 renal tubular acidosis both cause hypokalaemia

      Type 4 renal tubular acidosis causes hyperkalaemia.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      42
      Seconds
  • Question 22 - A patient presents with a history of renal problems, generalised weakness and palpitations....

    Correct

    • A patient presents with a history of renal problems, generalised weakness and palpitations. Her serum potassium levels are measured and come back at 6.2 mmol/L. An ECG is performed, and it shows some changes that are consistent with hyperkalaemia.
      Which of the following ECG changes is usually the earliest sign of hyperkalaemia? Select ONE answer only.

      Your Answer: Peaked T waves

      Explanation:

      Hyperkalaemia causes a rapid reduction in resting membrane potential leading to increased cardiac depolarisation and muscle excitability. This in turn results in ECG changes which can rapidly progress to ventricular fibrillation or asystole. Very distinctive ECG changes that progressively change as the K+level increases:
      K+>5.5 mmol/l – peaked T waves (usually earliest sign of hyperkalaemia), repolarisation abnormalities
      K+>6.5 mmol/l – P waves widen and flatten, PR segment lengthens, P waves eventually disappear
      K+>7.0 mmol/l – Prolonged QRS interval and bizarre QRS morphology, conduction blocks (bundle branch blocks, fascicular blocks), sinus bradycardia or slow AF, development of a sine wave appearance (a pre-terminal rhythm)
      K+>9.0 mmol/l – Cardiac arrest due to asystole, VF or PEA with a bizarre, wide complex rhythm.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      28.5
      Seconds
  • Question 23 - Campylobacter jejuni is primarily spread via which of the following routes: ...

    Correct

    • Campylobacter jejuni is primarily spread via which of the following routes:

      Your Answer: Faecal-oral route

      Explanation:

      Campylobacter spp. are a common cause of acute infective gastroenteritis, particularly in children, with Campylobacter jejuni responsible for 90% of Campylobacter gastroenteritis. Infection typically follows ingestion of contaminated meat (most frequently undercooked poultry), unpasteurised milk or contaminated water, following which the microorganism invades and colonises the mucosa of the small intestine.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      7.5
      Seconds
  • Question 24 - Regarding antacids, which of the following statements is CORRECT: ...

    Correct

    • Regarding antacids, which of the following statements is CORRECT:

      Your Answer: Antacids are contraindicated in hypophosphataemia.

      Explanation:

      Antacids are contraindicated in hypophosphataemia. Liquid preparations are more effective than tablet preparations. Magnesium-containing antacids tend to be laxative whereas aluminium-containing antacids tend to be constipating. Antacids are best taken when symptoms occur or are expected, usually between meals and at bedtime. Antacids should preferably not be taken at the same time as other drugs since they may impair absorption.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      6.7
      Seconds
  • Question 25 - A 49-year-old woman has a history of hypertension and persistent hypokalaemia and is...

    Correct

    • A 49-year-old woman has a history of hypertension and persistent hypokalaemia and is diagnosed with hyperaldosteronism.

      Which of these is the commonest cause of hyperaldosteronism?

      Your Answer: Adrenal adenoma

      Explanation:

      When there are excessive circulating levels of aldosterone, hyperaldosteronism occurs. There are two main types of hyperaldosteronism:

      Primary hyperaldosteronism (,95% of cases)
      Secondary hyperaldosteronism (,5% of cases)

      Primary causes of hyperaldosteronism include:
      Adrenal adenoma (Conn’s syndrome)
      Adrenal hyperplasia
      Adrenal cancer
      Familial aldosteronism
      Secondary causes of hyperaldosteronism include:
      Drugs
      Obstructive renal artery disease
      Renal vasoconstriction
      Oedematous disorders syndrome

      Adrenal adenoma is the commonest cause of hyperaldosteronism (seen in ,80% of all cases).

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      45.8
      Seconds
  • Question 26 - An analytical cohort study aimed to determine a relationship between intake of dietary...

    Correct

    • An analytical cohort study aimed to determine a relationship between intake of dietary calcium and incidence of hip fractures among post-menopausal women. The following are the data obtained from the study:

      No. of post-menopausal women who took Calcium: 500
      No. of post-menopausal women who took Calcium and suffered a hip fracture: 10

      No. of post-menopausal women who took placebo: 500
      No. of post-menopausal women who took placebo and suffered a hip fracture: 25

      Compute for the risk ratio of a hip fracture.

      Your Answer: 0.4

      Explanation:

      Relative risk (RR) is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.

      RR can be computed as the absolute risk of events in the treatment group (ART), divided by the absolute risk of events in the control group (ARC).

      RR = ART/ARC
      RR = (10/500) / (25/500)
      RR = 0.4

      Recall that:

      If RR < 1, then the intervention reduces the risk of the outcome.
      If RR = 1, then the treatment has no effect on the outcome.
      If RR > 1, then the intervention increases the risk of the outcome.

    • This question is part of the following fields:

      • Evidence Based Medicine
      5.5
      Seconds
  • Question 27 - What is the primary function of the mitochondria? ...

    Correct

    • What is the primary function of the mitochondria?

      Your Answer: The production of the cell's supply of chemical energy

      Explanation:

      The mitochondria is responsible for the production of the cell’s supply of chemical energy. It does this by using molecular oxygen, sugar and small fatty acid molecules to generate adenosine triphosphate (ATP) by a process ss known as oxidative phosphorylation. An enzyme called ATP synthase is required.

      Transcription of ribosomal RNA occurs in the nucleolus

      Production of messenger RNA occur in the nucleus

      Production of lysosome occurs in the Golgi apparatus

      The post-translational processing of newly made proteins occurs in the endoplasmic reticulum

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      21.9
      Seconds
  • Question 28 - A 57-year-old woman has presented with cough and shortness of breath. Her GP...

    Correct

    • A 57-year-old woman has presented with cough and shortness of breath. Her GP had done some blood tests recently and told her that she had a positive ANA result.

      Which of these statements is true about anti-nuclear antibodies (ANAs)? Select only ONE answer.

      Your Answer: The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome

      Explanation:

      Anti-nuclear antibodies are auto-antibodies directed against a variety of nuclear antigens. There are different staining patterns and each pattern is suggestive of a different disorder.

      Speckled staining is suggestive of mixed connective tissue disease.

      Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.

      Anti-double stranded DNA is suggestive of SLE while anti-histone antibodies are suggestive of drug-induced lupus.

      ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most accurate.

      The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome. Felty’s syndrome is characterized by a combination of rheumatoid arthritis, splenomegaly and neutropenia.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      41
      Seconds
  • Question 29 - You are treating a patient with a Clostridium difficile infection. His condition was...

    Correct

    • You are treating a patient with a Clostridium difficile infection. His condition was found to be antibiotic-associated. Which of the following pieces of advice on preventing the spread of this disease should you give this patient?

      Your Answer: Washing hands with soap and water

      Explanation:

      Clostridium difficile (C. diff) can cause colitis, or inflammation of the colon.

      To prevent its spread, one should practice good hand hygiene, regularly clean areas of the home that may become contaminated with C. difficile, practice good hand hygiene, and clean surfaces, spills, and accidents.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      24
      Seconds
  • Question 30 - Co-amoxiclav is used first line for which of the following indications: ...

    Correct

    • Co-amoxiclav is used first line for which of the following indications:

      Your Answer: Animal bite

      Explanation:

      Co-amoxiclav is used first line for infected and prophylaxis of infection in animal and human bites.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      9.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (3/4) 75%
Upper Limb (0/1) 0%
Evidence Based Medicine (1/2) 50%
Cardiovascular (1/1) 100%
Pharmacology (7/8) 88%
Microbiology (4/4) 100%
Specific Pathogen Groups (1/1) 100%
Central Nervous System (1/1) 100%
Thorax (1/1) 100%
Endocrine Physiology (2/2) 100%
Physiology (6/7) 86%
Haematology (1/2) 50%
Pathology (4/5) 80%
Fluids And Electrolytes (1/1) 100%
Infections (1/2) 50%
Abdomen And Pelvis (1/1) 100%
Basic Cellular Physiology (2/2) 100%
General Pathology (2/2) 100%
CNS Pharmacology (1/1) 100%
Renal (1/1) 100%
Immune Responses (1/1) 100%
Pathogens (2/2) 100%
Head And Neck (1/1) 100%
Cardiovascular Pharmacology (1/1) 100%
Renal Physiology (1/2) 50%
Gastrointestinal (1/1) 100%
Principles (1/1) 100%
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