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  • Question 1 - A 63-year-old man complains of chest pain and syncope on occasion. His heart...

    Incorrect

    • A 63-year-old man complains of chest pain and syncope on occasion. His heart rate is 37 beats per minute, and he has a second-degree heart block, according to his rhythm strip.

      Which of the following would be the most appropriate next step in his management, according to the ALS bradycardia algorithm?

      Your Answer: Set up transcutaneous pacing

      Correct Answer: Give atropine 500 mcg

      Explanation:

      Atropine is used to treat bradycardia (sinus, atrial, or nodal) or AV block when the patient’s haemodynamic condition is compromised by the bradycardia.

      If any of the following adverse features are present, the ALS bradycardia algorithm recommends a dose of atropine 500 mcg IV:
      Shock
      Syncope
      Myocardial ischemia
      Insufficiency of the heart

      If this does not work, give additional 500 mcg doses at 3-5 minute intervals until a maximum dose of 3 mg is reached. The heart rate can be slowed paradoxically if the dose is higher than 3 mg.

      The ALS bradycardia algorithm also suggests the following interim measures:
      Transcutaneous pacing
      Isoprenaline infusion 5 mcg/min
      Adrenaline infusion 2-10 mcg/minutes
      Alternative drugs (aminophylline, dopamine, glucagon, glycopyrrolate)

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      14
      Seconds
  • Question 2 - A 60-year-old man with insulin-controlled diabetes mellitus asks you about how his ability...

    Correct

    • A 60-year-old man with insulin-controlled diabetes mellitus asks you about how his ability to drive is affected. He owns a car as well as a motorcycle.

      Which of the following statements about driving with diabetes under insulin control is correct?

      Your Answer: He must monitor his blood glucose levels every 2 hours whilst driving

      Explanation:

      The DVLA sends a detailed information sheet about their licence and driving to all drivers with diabetes mellitus. The primary danger of driving while diabetic is hypoglycaemia.

      The DVLA must be notified of the following diabetic patients:
      All of the drivers are on insulin. (Licenses are being reviewed more frequently.)
      Those who are at high risk of hypoglycaemia and have had more than one episode of severe hypoglycaemia in the previous year. (Severe hypoglycaemia is defined as requiring the assistance of another person to manage.)
      Those who are unaware of their hypoglycaemia
      Anyone who has ever been in a car accident due to hypoglycaemia
      Anyone with diabetic retinopathy who needs laser treatment (to both eyes or to a second eye if sight only in one eye)
      Patients with diabetes complications that impair their ability to drive.

      To drive, drivers with insulin-treated diabetes must meet the following requirements:
      They need to be aware of hypoglycaemia.
      They must not have had more than one episode of hypoglycaemia in the previous 12 months that necessitated the assistance of another person.
      They must check their blood glucose levels no later than 2 hours before the first journey.
      While driving, they must check their blood glucose levels every two hours.
      The visual acuity and visual field standards must be met.

      Any significant changes in their condition must be reported to the DVLA. Furthermore, on days when they are not driving, group 2 licence holders must test their blood glucose twice daily using a metre that can store three months’ worth of readings.

      In addition to this advice, the DVLA also offers the following advice to diabetic patients:
      When taking tablets that have the potential to cause hypoglycaemia (such as sulfonylureas and glinides), monitoring may be necessary if there has been more than one episode of severe hypoglycaemia.
      Drivers must show good control and be able to recognise hypoglycaemia.
      Verify that your vision meets the required standard.

      If a patient feels hypoglycaemic or has a blood glucose level of less than 4.0 mmol/L, they should not drive. Driving should not be resumed until blood glucose levels have returned to normal, which should take 45 minutes.

      If there are any warning signs, patients should carry rapidly absorbed sugar in their vehicle and stop, turn off the ignition, and eat it.

      If resuscitation is required, a card stating which medications they are taking should be carried.

      If hypoglycaemia causes an accident, a diabetic driver may be charged with driving under the influence of drugs.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      35.3
      Seconds
  • Question 3 - You've been requested to give a discussion to a group of medical students...

    Incorrect

    • You've been requested to give a discussion to a group of medical students about cardiovascular physiology. One of them inquires about cardiac output and asks if you can explain it.

      Which of the following statements is correct?

      Your Answer: An average resting cardiac output in a man is 6 L/min

      Correct Answer: An average resting cardiac output in a woman is 5 L/min

      Explanation:

      The terminology cardiac output refers to the amount of blood pumped by the heart in one minute. Women’s rates are around 5 L/min, whereas men’s rates are somewhat higher, around 5.5 L/min.
      Cardiac output (CO) is calculated by multiplying stroke volume (SV) by heart rate (HR):
      CO = HR x SV

      As a result, both stroke volume and heart rate are exactly proportional to cardiac output. There will be an increase in cardiac output if the stroke volume or heart rate increases, and a reduction in cardiac output if the stroke volume or heart rate lowers.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      13.4
      Seconds
  • Question 4 - Cardiac myocytes are connected to each other by which of the following: ...

    Correct

    • Cardiac myocytes are connected to each other by which of the following:

      Your Answer: Intercalated discs

      Explanation:

      Adjacent cardiac myocytes are connected to each other by intercalated discs. The intercalated discs provide both a structural attachment by ‘glueing’ cells together at desmosomes and an electrical contact made up of proteins called connexons, called a gap junction, which essentially creates a low-resistance pathway between cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      4.7
      Seconds
  • Question 5 - A 14-year-old female is brought to the Emergency Room by her mother after...

    Correct

    • A 14-year-old female is brought to the Emergency Room by her mother after a fall from a tree in which she injured her elbow. An elbow fracture is suspected based on the examination findings, and she is given Entonox for analgesia as her elbow is set in a cast.

      Which one of the following statements regarding this drug is true?

      Your Answer: It can cause inhibition of vitamin B12 synthesis

      Explanation:

      Entonox is a mixture of 50% Oxygen and 50% nitrous oxide and is given in an inhaled form as a quick form of analgesia. Entonox causes non-competitive inhibition of NMDA (N-methyl-D-aspartate) receptors, which are a subtype of the glutamate receptor.

      It is stored in blue and white cylinders and administered via a pressure regulator and demand valve. The administration of this medicine reduces pain and anxiety in paediatric and dental procedures ands during labour.

      Effects are apparent after 20 seconds, and peak action occurs after 3 to 5 minutes as it is a drug with a rapid onset and the patient will also recover rapidly from its effects. Entonox is widely used as it does not accumulate in the body and does not cause many side effects. However, a notable side effect is the inhibition of Vitamin B12 synthesis.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      18.4
      Seconds
  • Question 6 - Which of the following statements is correct regarding paracetamol? ...

    Correct

    • Which of the following statements is correct regarding paracetamol?

      Your Answer: Liver damage peaks 3 to 4 days after paracetamol ingestion.

      Explanation:

      The maximum daily dose of paracetamol in an adult is 4 grams. Doses greater than this can lead to hepatotoxicity and, less frequently, acute kidney injury. Early symptoms of paracetamol toxicity include nausea, vomiting, and abdominal pain, and usually settle within 24 hours. Symptoms of liver damage include right subcostal pain and tenderness, and this peaks 3 to 4 days after paracetamol ingestion. Other signs of hepatic toxicity include encephalopathy, bleeding, hypoglycaemia, and cerebral oedema.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      11.5
      Seconds
  • Question 7 - In which part of the gastrointestinal tract is Meckel's diverticulum commonly located? ...

    Correct

    • In which part of the gastrointestinal tract is Meckel's diverticulum commonly located?

      Your Answer: Ileum

      Explanation:

      Meckel’s diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract, affecting approximately 2% of the general population. Meckel’s diverticulum are designated true diverticula because their walls contain all the layers found in normal small intestine. Their location varies among individual patients, but they are usually found in the ileum within 100 cm of the ileocecal valve.

      Approximately 60% of Meckel’s diverticulum contain heterotopic mucosa, of which over 60% consist of gastric mucosa. Pancreatic acini are the next most common; others include Brunner’s glands, pancreatic islets, colonic mucosa, endometriosis, and hepatobiliary tissues.

      A useful, although crude, mnemonic describing Meckel’s diverticulum is the “rule of twos”: 2% prevalence, 2:1 male predominance, location 2 feet proximal to the ileocecal valve in adults, and half of those who are symptomatic are under 2 years of age.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      201.8
      Seconds
  • Question 8 - Which statement concerning aerosol transmission is true? ...

    Correct

    • Which statement concerning aerosol transmission is true?

      Your Answer: They can be spread via ventilation systems in hospitals

      Explanation:

      Aerosols are airborne particles less than 5 µm in size containing infective organisms.

      They usually cause infection of both the upper and/or lower respiratory tract.

      The organisms can remain suspended in the air for long periods and also survive outside the body.

      They can be transmitted through the ventilation systems and can spread over great distances.

      Some examples of organisms transmitted by the aerosol route include: Varicella zoster virus, Mycobacterium tuberculosis and measles virus

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      585.3
      Seconds
  • Question 9 - Which of the following best describes a commensal: ...

    Correct

    • Which of the following best describes a commensal:

      Your Answer: An organism that is part of the normal flora

      Explanation:

      A commensal is an organism that is part of the normal flora.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      8.7
      Seconds
  • Question 10 - Which of the following best describes a pathogen: ...

    Correct

    • Which of the following best describes a pathogen:

      Your Answer: An organism that is capable of causing disease

      Explanation:

      A pathogen is an organism that is capable of causing disease.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      7.2
      Seconds
  • Question 11 - The most common type of adult leukaemia is chronic lymphocytic leukaemia (CLL). It...

    Correct

    • The most common type of adult leukaemia is chronic lymphocytic leukaemia (CLL). It develops as a result of lymphocyte clonal proliferation. Which of the following statements about CLL is CORRECT?

      Your Answer: It is most commonly discovered as an incidental finding

      Explanation:

      CLL (chronic lymphocytic leukaemia) is the most common type of chronic lymphoid leukaemia, with a peak incidence between the ages of 60 and 80. It is the most common type of leukaemia in Europe and the United States, but it is less common elsewhere.

      The CLL tumour cell is a mature B-cell with low immunoglobulin surface expression (IgM or IgD). The average age at diagnosis is 72 years, with only 15% of cases occurring before the age of 50.

      The male-to-female ratio is about 2:1. Over 80% of cases are identified by the results of a routine blood test, which is usually performed for another reason.

      Lymphocytic anaemia, thrombocytopenia, and normochromic normocytic anaemia are common laboratory findings. Aspiration of bone marrow reveals up to 95% lymphocytic replacement of normal marrow elements.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      44.8
      Seconds
  • Question 12 - An 18-year-old patient was brought to the ER after falling off of his...

    Incorrect

    • An 18-year-old patient was brought to the ER after falling off of his skateboard. He is unable to flex the distal interphalangeal joint of his index finger. You suspect that he suffers from a supracondylar fracture. Which of the following conditions would confirm supracondylar fracture?

      Your Answer: Inability to flex the distal interphalangeal joint of the ring finger

      Correct Answer: Inability to oppose the thumb

      Explanation:

      A supracondylar fracture is a fracture that occurs through the thin section of the distal humerus above the growth plate.

      A supracondylar fracture is most usually associated with median nerve injury. A medial nerve damage causes paralysis of the thenar muscles, as well as loss of thumb opposition.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      112.4
      Seconds
  • Question 13 - A 22 year old male has been stabbed and is brought to the...

    Incorrect

    • A 22 year old male has been stabbed and is brought to the ED with a stab wound to his upper limb. On examination, the patient is unable to flex the distal interphalangeal joints of the ring and little finger. However, the proximal interphalangeal joint is intact. The most likely affected nerve is which of the following, and at which level is this occurring?

      Your Answer: Median nerve at wrist

      Correct Answer: Ulnar nerve at elbow

      Explanation:

      The medial half of the flexor digitorum profundus is innervated by the ulnar nerve. Paralysis of this muscle results in loss of flexion at the distal interphalangeal joint of the ring and little finger.
      Flexion at the proximal interphalangeal joint is preserved as this is a function of the flexor digitorum superficialis which is innervated by the median nerve.
      The ulnar nerve is not correct as ulnar nerve injury at the wrist would not affect the long flexors, and the injury must have been more proximal.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      28.6
      Seconds
  • Question 14 - You examine a 43-year-old woman who was referred to you by a friend....

    Incorrect

    • You examine a 43-year-old woman who was referred to you by a friend. She suffers from a variety of medical conditions and takes a variety of medications, including amitriptyline.

      Which of the following is NOT a contraindication to amitriptyline treatment?

      Your Answer: Manic phase of bipolar affective disorder

      Correct Answer: Breastfeeding

      Explanation:

      Amitriptyline is a tricyclic antidepressant (TCA) that is most commonly used to treat depression, but it can also be used to treat anxiety disorders, chronic pain, and attention deficit hyperactivity disorder (ADHD). It inhibits reuptake, raising serotonin and noradrenaline levels while also inhibiting acetylcholine action.

      TCAs have a number of drawbacks, including:
      Acute Porphyria
      Arrhythmias
      During bipolar disorder’s manic phase
      Heart block
      After a myocardial infarction, there is an immediate recovery period.

      TCA levels in breast milk are too low to be harmful, and use can be continued while breastfeeding.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      36.9
      Seconds
  • Question 15 - A 54-year-old man with a long history of poorly controlled hypertension complains of...

    Correct

    • A 54-year-old man with a long history of poorly controlled hypertension complains of a headache and vision blurring today. In triage, his blood pressure is 210/192 mmHg. A CT head scan is scheduled to rule out the possibility of an intracranial haemorrhage. You make the diagnosis of hypertensive encephalopathy and rush the patient to reus to begin blood pressure-lowering treatment. He has a history of brittle asthma, for which he has been admitted to the hospital twice in the last year.

      Which of the following is the patient's preferred drug treatment?

      Your Answer: 25% of the mean arterial pressure over the first hour

      Explanation:

      End-organ damage (e.g. encephalopathy, intracranial haemorrhage, acute myocardial infarction or ischaemia, dissection, pulmonary oedema, nephropathy, eclampsia, papilledema, and/or angiopathic haemolytic anaemia) characterises a hypertensive emergency (also known as ‘accelerated hypertension’ or malignant hypertension’ It’s a life-threatening condition that necessitates rapid blood pressure reduction to avoid end-organ damage and a negative outcome.

      Hypertensive encephalopathy is a syndrome that includes headaches, seizures, visual changes, and other neurologic symptoms in people who have high blood pressure. It is reversible if treated quickly, but it can progress to coma and death if not treated properly.

      Any patient with suspected hypertensive encephalopathy should have an urgent CT scan to rule out an intracranial haemorrhage, as rapid blood pressure reduction could be dangerous in these circumstances.

      The drug of choice is labetalol, which reduces blood pressure steadily and consistently without compromising cerebral blood flow.
      An initial reduction of approximately 25% in mean arterial pressure (MAP) over an hour should be aimed for, followed by a further controlled MAP reduction over the next 24 hours. In patients who are unable to take beta-blockers, nicardipine can be used as a substitute.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      25.2
      Seconds
  • Question 16 - You are giving a presentation on the immune system as part of your...

    Correct

    • You are giving a presentation on the immune system as part of your peer-to-peer teaching sessions. Yu are currently discussing phagocytes. Macrophages are derived from which of the following cells:

      Your Answer: Monocytes

      Explanation:

      Monocytes spend only a short time in the marrow and, after circulating for 20-40 hours, leave the blood to enter the tissues where they become macrophages. Macrophages form the reticuloendothelial system in the liver, spleen and lymph nodes. The lifespan of macrophages may be as long as several months or even years. In tissues the macrophages become self-replicating without replenishment from the blood. They assume specific functions in different tissues e.g. dendritic cells which are involved in antigen presentation to T-cells. Macrophages may be activated by cytokines such as IFN-gamma, contact with complement or direct contact with the target cell through leucocyte adhesion molecules.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      9.9
      Seconds
  • Question 17 - What is the main mechanism of action of cyclizine: ...

    Incorrect

    • What is the main mechanism of action of cyclizine:

      Your Answer: Histamine-H2 antagonist

      Correct Answer: Histamine-H1 antagonist

      Explanation:

      Antihistamines e.g. cyclizine, are effective against nausea and vomiting caused by many different conditions, including motion sickness and vertigo. These agents act by inhibiting histamine pathways, and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. There is no evidence that any one antihistamine is superior to another but their duration of action and incidence of adverse effects differ. Adverse effects include drowsiness and antimuscarinic effects such as blurred vision, dry mouth, urinary retention, constipation and confusion.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      13.9
      Seconds
  • Question 18 - A type II error occurs when: ...

    Correct

    • A type II error occurs when:

      Your Answer: The null hypothesis is accepted when it is false.

      Explanation:

      A type II error occurs when the null hypothesis is wrongly accepted when it is actually false and we conclude that there is no evidence of a difference in effect when one really exists (a false negative result).

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      6.2
      Seconds
  • Question 19 - Which of the following statements accurately describes the flexor digitorum superficialis muscle? ...

    Incorrect

    • Which of the following statements accurately describes the flexor digitorum superficialis muscle?

      Your Answer: It receives its blood supply from the brachial artery

      Correct Answer: It flexes the middle phalanges of the medial four fingers at the proximal interphalangeal joints

      Explanation:

      Flexor digitorum superficialis is the largest muscle of the anterior compartment of the forearm. It belongs to the superficial flexors of the forearm, together with pronator teres, flexor carpi radialis, flexor carpi ulnaris and palmaris longus. Some sources alternatively classify this muscle as an independent middle/intermediate layer of the anterior forearm, found between the superficial and deep groups.

      Flexor digitorum superficialis is innervated by muscular branches of the median nerve, derived from roots C8 and T1 that arises from the medial and lateral cords of the brachial plexus. The skin that overlies the muscle is supplied by roots C6-8 and T1.

      The primary arterial blood supply to the flexor digitorum superficialis is derived from the ulnar artery and its anterior recurrent branch. In addition to branches of the ulnar artery, the anterior and lateral surfaces of the muscle are supplied by branches of the radial artery; and its posterior surface also receives branches from the median artery.

      The main function of flexor digitorum superficialis is flexion of the digits 2-5 at the proximal interphalangeal and metacarpophalangeal joints. Unlike the flexor digitorum profundus, flexor digitorum superficialis has independent muscle slips for all four digits. This allows it to flex the digits individually at their proximal interphalangeal joints. In addition, flexor digitorum superficialis aids the aids flexion of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.3
      Seconds
  • Question 20 - The weight distribution in a group of patients included in a study was...

    Incorrect

    • The weight distribution in a group of patients included in a study was normal. The patients averaged 80 kg in weight. 5 kg was determined to be the standard deviation. Which of the following statements most accurately describes this group of patients:

      Your Answer: 95% of the patients will weigh between 75 and 85 kg.

      Correct Answer: 68% of the patients will weigh between 75 and 85 kg.

      Explanation:

      We can estimate the range of values that would be anticipated to include particular proportions of observations if we know the mean and standard deviation of a collection of normally distributed data: 68.2 percent of the sample results fall within a one SD range above and below the mean (+/- 1 SD), implying that 68 percent of the patients will weigh between 75 and 85 kg. Because +/- 2 SD encompasses 95.4 percent of the data, around 95 percent of the patients will weigh between 70 and 90 kg. +/- 3 SD encompasses 99.7% of the values, implying that nearly all of the patients will weigh between 65 and 95 kg.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      12.8
      Seconds
  • Question 21 - In the foetus at 4 months gestation, where does haematopoiesis mainly occur? ...

    Incorrect

    • In the foetus at 4 months gestation, where does haematopoiesis mainly occur?

      Your Answer: Marrow of axial skeleton

      Correct Answer: Liver and spleen

      Explanation:

      The first place that haematopoiesis occurs in the foetus is in the yolk sac. Later on, it occurs in the liver and spleen, which are the major hematopoietic organs from about 6 weeks until 6 – 7 months gestation. At this point, the bone marrow becomes the most important site. Haemopoiesis is restricted to the bone marrow in normal childhood and adult life.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      7.8
      Seconds
  • Question 22 - Following an injury sustained during a rugby match, a 16-year-old boy is brought...

    Correct

    • Following an injury sustained during a rugby match, a 16-year-old boy is brought to the Emergency Department by his mother. His forearm appears to be deformed, and you believe he has a distal radius fracture. A numerical rating scale is used to assess his pain, and the triage nurse informs you that he is in moderate pain.'

      The RCEM guidance recommends which of the following analgesics for the treatment of moderate pain in a child of this age?

      Your Answer: Oral codeine phosphate 1 mg/kg

      Explanation:

      According to a 2018 audit conducted by the Royal College of Emergency Medicine (RCEM), the standard of care for children presenting to EDs with fractured limbs has deteriorated, with most patients waiting longer than ever before for pain relief. More than one-tenth of the children who came in with significant pain from a limb fracture received no pain relief at all.

      For all patients, including children, the Agency for Health Care Policy and Research (AHCPR) in the United States recommends using the ABCs of pain management:
      A – Ask about pain regularly. Assess pain systematically.
      B – Believe the patient and family in their reports of pain and what relieves it.
      C – Choose pain control options appropriate for the patient, family, and setting.
      D – Deliver interventions in a timely, logical, coordinated fashion.
      E – Empower patients and their families. Enable patients to control their course to the greatest extent possible.

      The RCEM guidelines recommend assessing a child’s pain within 15 minutes of arrival. This is a fundamental requirement. For the assessment of pain in children, a variety of rating scales are available; which one is used depends on the child’s age and ability to use the scale. These are some of them:
      Faces of Wong-Baker Scale for assessing pain
      Scale of numerical evaluation
      The behavioural scale is a scale that measures how people behave.

      The RCEM has provided the following visual guide:
      The RCEM has established the following guidelines for when patients in severe pain should receive appropriate analgesia:
      100% within 60 minutes of arrival or triage, whichever is earliest
      75% within 30 minutes of arrival or triage, whichever is earliest
      50% within 20 minutes of arrival or triage, whichever is earliest

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      10.2
      Seconds
  • Question 23 - The Philadelphia chromosome is a genetic abnormality associated primarily with which of the...

    Correct

    • The Philadelphia chromosome is a genetic abnormality associated primarily with which of the following malignancies:

      Your Answer: Chronic myeloid leukaemia

      Explanation:

      Chronic myeloid leukaemia (CML) is a clonal disorder of a pluripotent stem cell. The disease accounts for around 15% of leukaemias and may occur at any age. The diagnosis of CML is rarely difficult and is assisted by the characteristic presence of the Philadelphia (ph) chromosome. This disease occurs in either sex, most frequently between the ages of 40 and 60 years. In up to 50% of cases the diagnosis is made incidentally from a routine blood count. Leucocytosis is the main feature, with a complete spectrum of myeloid cells seen in the peripheral blood. The levels of neutrophils and myelocytes exceed those of blast cells and promyelocytes.Increased circulating basophils are a characteristic feature. Normochromic normocytic anaemia is usual. Platelet count may be increased (most frequently), normal or decreased. The clinical outlook is very good and 90% of patients can expect long-term control of disease.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      17.4
      Seconds
  • Question 24 - Regarding antiemetics, which of the following statements is INCORRECT: ...

    Correct

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

      Your Answer: Of the antiemetics, cyclizine is most commonly associated with acute dystonic reactions.

      Explanation:

      Cyclizine acts by inhibiting histamine pathways and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. Metoclopramide is a dopamine-receptor antagonist which acts both peripherally in the GI tract and centrally within the chemoreceptor trigger zone. Prochlorperazine is a dopamine-D2 receptor antagonist and acts centrally by blocking the chemoreceptor trigger zone. Metoclopramide and prochlorperazine are both commonly associated with extrapyramidal effects, such as acute dystonic reaction. Cyclizine may rarely cause extrapyramidal effects.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      20.7
      Seconds
  • Question 25 - Which of the following statements about vitamin B12 absorption is TRUE: ...

    Incorrect

    • Which of the following statements about vitamin B12 absorption is TRUE:

      Your Answer: Receptors for the vitamin B12/Intrinsic factor complex are found in the duodenum allowing uptake of vitamin B12.

      Correct Answer: On ingestion, vitamin B12 is bound to R protein which protects it from digestion in the stomach.

      Explanation:

      The substance intrinsic factor,
      essential for absorption of vitamin B12 in the ileum, is
      secreted by the parietal cells along with the secretion of
      hydrochloric acid. When the acid-producing parietal
      cells of the stomach are destroyed, which frequently
      occurs in chronic gastritis, the person develops not only
      achlorhydria (lack of stomach acid secretion) but often
      also pernicious anaemia because of failure of maturation
      of the red blood cells in the absence of vitamin B12 stimulation of the bone marrow.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      16.7
      Seconds
  • Question 26 - Which of the following factors decreases insulin secretion: ...

    Incorrect

    • Which of the following factors decreases insulin secretion:

      Your Answer: Acetylcholine

      Correct Answer: Catecholamines

      Explanation:

      Factors that increase insulin secretion:
      ↑ Blood glucose
      ↑ Amino acids
      ↑ Fatty acids
      Glucagon
      Secretin
      Acetylcholine

      Factors that decrease insulin secretion:
      ↓ Blood glucose
      Somatostatin
      Catecholamines

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      16.7
      Seconds
  • Question 27 - Which of the following is NOT a side effect of phenytoin: ...

    Incorrect

    • Which of the following is NOT a side effect of phenytoin:

      Your Answer: Acne and hirsutism

      Correct Answer: Ototoxicity

      Explanation:

      Adverse effects of phenytoin include:
      Nausea and vomiting
      Drowsiness, lethargy, and loss of concentration
      Headache, dizziness, tremor, nystagmus and ataxia
      Gum enlargement or overgrowth
      Coarsening of facial features, acne and hirsutism
      Skin rashes
      Blood disorders

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      7.6
      Seconds
  • Question 28 - Which of these is NOT a lithium side effect: ...

    Correct

    • Which of these is NOT a lithium side effect:

      Your Answer: Peptic ulcer disease

      Explanation:

      Adverse Effects of lithium Include

      Leucocytosis (most patients)
      Polyuria/polydipsia (30-50%)
      Dry mouth (20-50%)
      Hand tremor (45% initially, 10% after 1 year of treatment)
      Confusion (40%)
      Decreased memory (40%)
      Headache (40%)
      Muscle weakness (30% initially, 1% after 1 year of treatment)
      Electrocardiographic (ECG) changes (20-30%)
      Nausea, vomiting, diarrhoea (10-30% initially, 1-10% after 1-2 years of treatment)
      Hyperreflexia (15%)
      Muscle twitch (15%)
      Vertigo (15%)
      Extrapyramidal symptoms, goitre (5%)
      Hypothyroidism (1-4%)
      Acne (1%)
      Hair thinning (1%)

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      5.4
      Seconds
  • Question 29 - Regarding cross-sectional studies, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding cross-sectional studies, which of the following statements is CORRECT:

      Your Answer: They are particularly suitable for estimating incidence of a disease.

      Correct Answer: They are particularly suitable for estimating point prevalence.

      Explanation:

      Cross-sectional studies aim to provide data about population health, normal ranges of biological parameters, and disease prevalence or severity by observing the entire population, or a representative subset, at a single point in time. Cross-sectional studies are relatively simple and quick to perform and can be used to study multiple outcomes, but are subject to confounding and recall bias and are not suitable for studying rare diseases. Cross-sectional studies cannot be used to assess causation or to consider trends over time.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      8.1
      Seconds
  • Question 30 - Which of the following presentations is NOT consistent with the diagnosis of anaphylaxis...

    Incorrect

    • Which of the following presentations is NOT consistent with the diagnosis of anaphylaxis following exposure to a known allergen:

      Your Answer: Dyspnoea, tachypnoea, wheeze and hypoxia with no skin or mucosal changes

      Correct Answer: Generalised urticaria and angioedema alone

      Explanation:

      Anaphylaxis is characterised by sudden onset and rapidly developing, life-threatening airway, breathing and circulation problems associated with skin and/or mucosal changes. Reactions can vary greatly, from hypotension alone, to reactions with predominantly asthmatic features, to cardiac/respiratory arrest. Skin or mucosal changes may be absent or subtle in up to 20% of cases but skin or mucosal changes alone are not a sign of an anaphylactic reaction.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      20
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular Pharmacology (1/2) 50%
Pharmacology (7/12) 58%
Endocrine Pharmacology (1/1) 100%
Cardiovascular Physiology (0/1) 0%
Physiology (1/5) 20%
Cardiovascular (1/1) 100%
Anaesthesia (1/1) 100%
Central Nervous System (3/5) 60%
Abdomen And Pelvis (1/1) 100%
Anatomy (1/4) 25%
Microbiology (3/3) 100%
Principles Of Microbiology (1/1) 100%
Principles (2/2) 100%
Haematology (2/2) 100%
Pathology (3/3) 100%
Upper Limb (0/3) 0%
CNS Pharmacology (1/2) 50%
Immune Responses (1/1) 100%
Evidence Based Medicine (1/3) 33%
Statistics (1/2) 50%
Basic Cellular (0/1) 0%
Gastrointestinal (0/1) 0%
Endocrine (0/1) 0%
Study Methodology (0/1) 0%
Respiratory (0/1) 0%
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