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  • Question 1 - A 2nd-year medical student is solving an exam paper with questions about the...

    Correct

    • A 2nd-year medical student is solving an exam paper with questions about the immune system. She comes across a question regarding innate immunity. Innate immunity is the immunity naturally present within the body from birth.

      Which ONE of the following is not a part of this type of immunity?

      Your Answer: Antibody production

      Explanation:

      Innate immunity, also called non-specific immunity, refers to the components of the immune system naturally present in the body at birth.

      The components of innate immunity include:
      1) Natural Killer Cells
      2) Neutrophils
      3) Macrophages
      4) Mast Cells
      5) Dendritic Cells
      6) Basophils.

      Acquired or adaptive immunity is acquired in response to infection or vaccination. Although the response takes longer to develop, it is also a more long-lasting form of immunity.

      The components of this system include:
      1) T lymphocytes
      2) B lymphocytes
      3) Antibodies

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      12.5
      Seconds
  • Question 2 - A 20-year-old male patient lives in a travelling community and has never...

    Correct

    • A 20-year-old male patient lives in a travelling community and has never received any vaccinations. He presents to you with fever.

      Which of these statements concerning indications and contraindications for vaccination is FALSE?

      Your Answer: Premature infants should have the their immunisation schedule adjusted for gestational age

      Explanation:

      All vaccines are contraindicated in individuals with:
      A confirmed anaphylactic reaction to a previous dose of the vaccine or a vaccine containing the same antigens.
      A confirmed anaphylactic reaction to a component in the vaccine e.g. neomycin

      Live attenuated vaccines are contraindicated in pregnancy except in cases where risk of infection is more than the risks of vaccination.

      During times of acute febrile illness, vaccination should be avoided.

      12 weeks should elapse after a dose of human immunoglobulin before a live vaccine is administered.

      The normal times recommended for immunization of full-term babies should also be applied to premature infants and correction for gestational age should NOT be implemented.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      49
      Seconds
  • Question 3 - 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
      22
      Seconds
  • Question 4 - A 32 year old woman presents with episodes of flushing, headaches and palpitations....

    Correct

    • A 32 year old woman presents with episodes of flushing, headaches and palpitations. On examination her blood pressure is significantly elevated. Which of the following is the most likely diagnosis:

      Your Answer: Pheochromocytoma

      Explanation:

      Phaeochromocytomas are catecholamine-secreting tumours which occur in about 0.1% of patients with hypertension. In about 90% of cases they arise from the adrenal medulla. The remaining 10%, which arise from extra-adrenal chromaffin tissue, are termed paragangliomas. Common presenting symptoms include one or more of headache, sweating, pallor and palpitations. Less commonly, patients describe anxiety, panic attacks and pyrexia. Hypertension, whether sustained or episodic, is present in at least 90% of patients. Left untreated phaeochromocytoma can occasionally lead to hypertensive crisis, encephalopathy, hyperglycaemia, pulmonary oedema, cardiac arrhythmias, or even death.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      18.8
      Seconds
  • Question 5 - Which of the following acts to inhibit antidiuretic hormone (ADH) release from the...

    Correct

    • Which of the following acts to inhibit antidiuretic hormone (ADH) release from the posterior pituitary:

      Your Answer: Atrial natriuretic peptide

      Explanation:

      ADH release is inhibited by low plasma osmolality, alcohol, caffeine, glucocorticoids and atrial natriuretic peptide (ANP).

      ADH release is stimulated primarily by raised plasma osmolality detected by osmoreceptors in the anterior hypothalamus. Other factors that increase ADH release include: extracellular fluid volume depletion, angiotensin II, nausea, pain, stress, exercise, emotion, hypoglycaemia.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      9.3
      Seconds
  • Question 6 - A 17-year-old male presenting in the department has a history of C3 deficiency.

    C3...

    Incorrect

    • A 17-year-old male presenting in the department has a history of C3 deficiency.

      C3 deficiency is associated with all of the following EXCEPT?

      Your Answer: Systemic lupus erythematosus

      Correct Answer: Hereditary angioedema

      Explanation:

      C1-inhibitor deficiency is the cause of hereditary angioedema not C3 deficiency,

      All the other statements are correct

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      17.8
      Seconds
  • Question 7 - A 23-year-old man is discovered to have an infection from Helicobacter pylori.

    Which...

    Incorrect

    • A 23-year-old man is discovered to have an infection from Helicobacter pylori.

      Which of the following types of cancer is mostly associated with Helicobacter pylori infection?

      Your Answer: Colon cancer

      Correct Answer: Gastric cancer

      Explanation:

      H. pylori is recognized as a major cause of type B gastritis, a chronic condition formerly associated primarily with stress and chemical irritants. In addition, the strong association between long-term H. pylori infection and gastric cancer has raised more questions regarding the clinical significance of this organism. There is speculation that long-term H. pylori infection resulting in chronic gastritis is an important risk factor for gastric carcinoma resulting in H. pylori being classified as a carcinogen.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      25
      Seconds
  • Question 8 - Which of the following statements is INCORRECT. Fick's law tells us that the...

    Incorrect

    • Which of the following statements is INCORRECT. Fick's law tells us that the rate of diffusion of a gas across a membrane increases as:

      Your Answer: the thickness of the cell membrane decreases.

      Correct Answer: the partial pressure gradient decreases.

      Explanation:

      Fick’s law tells us that the rate of diffusion of a gas increases:
      the larger the surface area involved in gas exchange
      the greater the partial pressure gradient across the membrane
      the thinner the membrane
      the more soluble the gas in the membrane
      the lower the molecular weight of the gas

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      9.7
      Seconds
  • Question 9 - Your consultant decides to use ketamine for a patient requiring procedural sedation in...

    Incorrect

    • Your consultant decides to use ketamine for a patient requiring procedural sedation in the Emergency Department. At what receptor does ketamine primarily act:

      Your Answer: Nicotinic receptor

      Correct Answer: NMDA receptor

      Explanation:

      In contrast to most other anaesthetic agents, ketamine is a NMDA (N-methyl-D-aspartate) receptor antagonist. It is a non-competitive antagonist of the calcium-ion channel in the NMDA receptor. It further inhibits the NMDA-receptor by binding to its phencyclidine binding site. Ketamine also acts at other receptors as an opioid receptor agonist (analgesic effects), as an muscarinic anticholinergic receptor antagonist (antimuscarinic effects) and by blocking fast sodium channels (local anaesthetic effect).

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      11.8
      Seconds
  • Question 10 - The most common site of ectopic pregnancy is? ...

    Incorrect

    • The most common site of ectopic pregnancy is?

      Your Answer: Isthmus of Fallopian tube

      Correct Answer: Ampulla of Fallopian tube

      Explanation:

      Nearly 95% of ectopic pregnancies are implanted in the various segments of the fallopian tube and give rise to fimbrial, ampullary, isthmic, or interstitial tubal pregnancies. The ampulla is the most frequent site, followed by the isthmus. The remaining 5% of non tubal ectopic pregnancies implant in the ovary, peritoneal cavity, cervix, or prior caesarean scar.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      34.2
      Seconds
  • Question 11 - In which of the following cases is intravenous phenytoin contraindicated? ...

    Incorrect

    • In which of the following cases is intravenous phenytoin contraindicated?

      Your Answer: Hepatic impairment

      Correct Answer: Second degree heart block

      Explanation:

      Phenytoin Contraindications include:

      Hypersensitivity
      Sinus bradycardia
      Sinoatrial block
      Second and third degree A-V block
      Adams-Stokes syndrome
      Concurrent use with delavirdine
      History of prior acute hepatotoxicity attributable to phenytoin

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      26.7
      Seconds
  • Question 12 - An 11-year-old presented to a GP with a history of headache, neck stiffness...

    Incorrect

    • An 11-year-old presented to a GP with a history of headache, neck stiffness and photophobia. On examination, HR is 122, BP is 87/42, RR is 28, SaO 2 is 95%, temperature is 39.4 o C. There is a recent petechial rash on legs and arms. The GP administered a dose of antibiotics in the prehospital setting before transferring to the Emergency Department. Which of these would the GP have administered?

      Your Answer: IM benzylpenicillin 600 mg

      Correct Answer: IM benzylpenicillin 1.2 g

      Explanation:

      General Practitioners are advised to give a single injection of benzylpenicillin by intravenous or intramuscular injection before transferring the patient urgently to the ED when bacterial meningitis is suspected.

      The recommended doses are:
      Infants under 1 year: 300 mg
      Children ages 1 to 9 years: 600 mg
      Children aged 10 years and over: 1.2g
      Adults: 1.2g

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      29.9
      Seconds
  • Question 13 - A 54-year-old man who is acutely unwell has his blood sent for test...

    Incorrect

    • A 54-year-old man who is acutely unwell has his blood sent for test and the results come back with a CRP of 115.

      Which of these statements about C-reactive protein is FALSE?

      Your Answer: The normal plasma concentration is less than 5 mg/l

      Correct Answer: It is produced in the bone marrow

      Explanation:

      C-reactive protein(CRP) is synthesized in the liver in response to increased interleukin-6 (IL-6) secretion by macrophages and T-cells.
      Some conditions that cause CRP levels to a rise include: bacterial infection, fungal infection, severe trauma, autoimmune disease, Organ tissue necrosis, malignancy and surgery.

      It is useful in the clinical setting as a marker of inflammatory activity and can be used to monitor infections.

      CRP levels start to rise 4-6 hours after an inflammatory trigger and reaches peak levels at 36-50 hours.

      In the absence of a disease process, the normal plasma concentration is less than 5 mg/l.

      CRP is useful for monitoring inflammatory conditions (e.g. rheumatoid arthritis and malignancy), can be used as a prognostic marker in acute pancreatitis, and serial measurement can be used to recognize the onset of nosocomial infections in the intensive care settling.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      34.7
      Seconds
  • Question 14 - A patient has a diagnosis of acute osteomyelitis. They have no joint prosthesis...

    Incorrect

    • A patient has a diagnosis of acute osteomyelitis. They have no joint prosthesis on indwelling metal work and no known drug allergies. He has had a recent skin swab that has cultured MRSA and MRSA infection is suspected.
      Which of the following antibacterial agents would be most appropriate to prescribe in this case? Select ONE answer only.

      Your Answer: Flucloxacillin

      Correct Answer: Vancomycin

      Explanation:

      In the majority of patients the commonest causative organism for osteomyelitis isStaphylococcus aureus.Salmonella spp. are the commonest cause in patients with sickle cell disease.
      Other bacteria that can cause osteomyelitis include:
      Enterobacter spp.
      Group A and B streptococcus
      Haemophilus influenzae
      The current recommendations by NICE and the BNF on the treatment of osteomyelitis are:
      Flucloxacillin first-line
      Consider adding fusidic acid or rifampicin for initial 2 weeks
      If penicillin allergic use clindamycin
      If MRSA is suspected use vancomycin
      Suggested duration of treatment is 6 weeks for acute infection

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      2.8
      Seconds
  • Question 15 - 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
      15.2
      Seconds
  • Question 16 - What is the primary route of transmission of Neisseria Gonorrhoeae? ...

    Incorrect

    • What is the primary route of transmission of Neisseria Gonorrhoeae?

      Your Answer: Direct skin contact

      Correct Answer: Sexually transmitted

      Explanation:

      Neisseria gonorrhoeae is primarily spread by sexual contact or through transmission during childbirth. It causes gonorrhoea which is a purulent infection of the mucous membrane surfaces.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      9.1
      Seconds
  • Question 17 - Which of the following is NOT an indication for a H1 receptor antihistamine:...

    Incorrect

    • Which of the following is NOT an indication for a H1 receptor antihistamine:

      Your Answer: Insomnia

      Correct Answer: Gastroesophageal reflux disease

      Explanation:

      Antihistamines are competitive inhibitors at the H1-receptor (in contrast to H2 receptor antagonists used to decrease gastric acid secretion in gastroesophageal reflux disease).
      Indications:
      Allergic rhinitis and conjunctivitis
      Urticarial rashes, pruritus, insect bites and stings
      Angioedema
      Anaphylaxis (second line adjunct to adrenaline)
      Nausea/vomiting and prevention of motion sickness
      Insomnia

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      19.6
      Seconds
  • Question 18 - A patient suffers a lower limb fracture that causes damage to the nerve...

    Incorrect

    • A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus longus.
      Peroneus longus receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Obturator nerve

      Correct Answer: Superficial peroneal nerve

      Explanation:

      Peroneus brevis is innervated by the superficial peroneal nerve.
      Peroneus longus is innervated by the superficial peroneal nerve.
      Peroneus tertius is innervated by the deep peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.6
      Seconds
  • Question 19 - A patient with a history of worsening chronic breathlessness on exertion undergoes lung...

    Incorrect

    • A patient with a history of worsening chronic breathlessness on exertion undergoes lung function testing. The results demonstrate an FEV 1 that is 58% predicted and an FEV 1 /FVC ratio less than 0.7.
      Which of the following is the most likely diagnosis? Select ONE answer only.

      Your Answer: Scoliosis

      Correct Answer: COPD

      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

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      40.6
      Seconds
  • Question 20 - Intrinsic factor is vital for gastrointestinal absorption of which of the following: ...

    Incorrect

    • Intrinsic factor is vital for gastrointestinal absorption of which of the following:

      Your Answer: Iron

      Correct Answer: Vitamin B12

      Explanation:

      Intrinsic factor is essential for the absorption of the small amounts of vitamin B12 normally present in the diet from the terminal ileum. The parietal cells of the stomach produce intrinsic factor, and following a gastrectomy, the absorption of vitamin B12 will be markedly reduced, and a deficiency state will exist.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      9
      Seconds
  • Question 21 - Regarding postural hypotension, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding postural hypotension, which of the following statements is INCORRECT:

      Your Answer: Symptoms of dizziness or blurred vision are due to a transient fall in cerebral perfusion.

      Correct Answer: Postural hypotension usually causes a reflex bradycardia.

      Explanation:

      On standing from a prone position, gravity causes blood to pool in veins in the legs. Central venous pressure (CVP) falls, causing a fall in stroke volume and cardiac output (due to Starling’s law) and thus a fall in blood pressure. Normally this fall in BP is rapidly corrected by the baroreceptor reflex which causes venoconstriction (partially restoring CVP), and an increase in heart rate and contractility, so restoring cardiac output and blood pressure. Impaired autonomic nervous activity in the elderly accounts for the greater likelihood of postural hypotension. Any symptoms of dizziness, blurred vision or syncope is due to a transient fall in cerebral perfusion that occurs before cardiac output and mean arterial pressure (MAP) can be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      19.2
      Seconds
  • Question 22 - When a child has mumps, how long should he or she be off...

    Correct

    • When a child has mumps, how long should he or she be off from school?

      Your Answer: 5 days from onset of swelling

      Explanation:

      To avoid the spread of infection, infected patients should be isolated. Patients should avoid going to school, childcare, or job for five days after the swelling has occurred.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      12.2
      Seconds
  • Question 23 - The big toe of a 59-year-old female is red, hot, and swollen. The patient is...

    Correct

    • The big toe of a 59-year-old female is red, hot, and swollen. The patient is diagnosed with acute gout. You intend to start her on a nonsteroidal anti-inflammatory medicine (NSAID). Her husband was diagnosed with a peptic ulcer, and she is apprehensive about the potential adverse effects of NSAIDs.

      Which of the following NSAIDs has the lowest chance of causing side effects?

      Your Answer: Ibuprofen

      Explanation:

      Non-steroidal anti-inflammatory medications (NSAIDs) have slight differences in anti-inflammatory activity, but there is a lot of diversity in individual response and tolerance to these treatments. Approximately 60% of patients will respond to any NSAID; those who do not respond to one may well respond to another. Pain relief begins soon after the first dose, and a full analgesic effect should be achieved within a week, whereas an anti-inflammatory effect may take up to three weeks to achieve (or to be clinically assessable). If the desired results are not reached within these time frames, another NSAID should be attempted.

      By inhibiting the enzyme cyclo-oxygenase, NSAIDs limit the generation of prostaglandins. They differ in their selectivity for inhibiting various types of cyclo-oxygenase; selective inhibition of cyclo-oxygenase-2 is linked to reduced gastrointestinal discomfort. Susceptibility to gastrointestinal effects is influenced by a number of different parameters, and an NSAID should be chosen based on the frequency of side effects.
      Ibuprofen is an anti-inflammatory, analgesic, and antipyretic propionic acid derivative. Although it has fewer side effects than other non-selective NSAIDs, its anti-inflammatory properties are less effective. For rheumatoid arthritis, daily doses of 1.6 to 2.4 g are required, and it is contraindicated for illnesses characterized by inflammation, such as acute gout.

      Because it combines strong efficacy with a low incidence of adverse effects, Naproxen is one of the top choices. It is more likely to cause negative effects than ibuprofen.
      Similar to ibuprofen, ketoprofen and diclofenac have anti-inflammatory characteristics, however they have additional negative effects.

      Indomethacin has a similar or better effect to naproxen, however it comes with a lot of side effects, such as headaches, dizziness, and gastrointestinal problems.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      18.5
      Seconds
  • Question 24 - Innate, or non-specific, immunity is the immune system we are born with.
    Which of...

    Incorrect

    • Innate, or non-specific, immunity is the immune system we are born with.
      Which of the following is NOT an example of innate immunity? Select ONE answer only.

      Your Answer: Enzymes in tears

      Correct Answer: T-lymphocytes

      Explanation:

      Innate, or non-specific, immunity is the immune system we are born with.
      There are three aspects of innate immunity:
      1. Anatomical barriers, such as:
      The cough reflex
      Enzymes in tears and skin oils
      Mucus – which traps bacteria and small particles
      Skin
      Stomach acid
      2. Humoral barriers, such as:
      The complement system
      Interleukin-1
      3. Cellular barriers, such as:
      Neutrophils
      Macrophages
      Dendritic cells
      Natural killer cells
      Antibody production is part of the specific, or inducible immune response. T-lymphocytesare responsible for the cell mediated immune response which is part of specific, or inducible immunity.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      6.6
      Seconds
  • Question 25 - Which of the following study designs is considered the most appropriate to safely...

    Incorrect

    • Which of the following study designs is considered the most appropriate to safely determine whether an association exists between a well-established, commonly used, anti-hypertensive medication and causing type II diabetes mellitus?

      Your Answer: A case-control study

      Correct Answer: A meta-analysis

      Explanation:

      Evidence-based medicine may be defined as the systematic, quantitative, preferentially experimental approach to obtaining and using medical information. Therefore, meta-analysis, a statistical procedure that integrates the results of several independent studies, plays a central role in evidence-based medicine.

      Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess previous research studies to derive conclusions about that body of research. Outcomes from a meta-analysis may include a more precise estimate of the effect of treatment or risk factor for disease, or other outcomes, than any individual study contributing to the pooled analysis.

    • This question is part of the following fields:

      • Evidence Based Medicine
      21.1
      Seconds
  • Question 26 - Which of the following diseases is caused by a build-up of lymphoblasts in...

    Incorrect

    • Which of the following diseases is caused by a build-up of lymphoblasts in the bone marrow?

      Your Answer: Acute myeloid leukaemia

      Correct Answer: Acute lymphoblastic leukaemia

      Explanation:

      Acute lymphoblastic leukaemia (ALL) is a clonal (malignant) bone marrow disorder in which early lymphoid precursors multiply and replace the marrow’s normal hematopoietic cells. ALL is most common between the ages of 3 and 7, with 75 percent of cases occurring before the age of 6.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      15.3
      Seconds
  • Question 27 - A 32 year old man is brought to ED having been thrown off...

    Incorrect

    • A 32 year old man is brought to ED having been thrown off his motorbike. Following initial resuscitation and ruling out life-threatening injuries, you establish the patient has weakness of hip flexion. Which of the following nerves has most likely been injured:

      Your Answer:

      Correct Answer: Femoral nerve

      Explanation:

      Flexion of the hip is produced by the iliacus, the psoas major, the sartorius, rectus femoris and the pectineus muscles. The femoral nerve innervates the iliacus, pectineus, sartorius and quadriceps femoris muscles, and supplies skin on the anterior thigh, anteromedial knee and medial leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 28 - All of the following cause bronchodilation, EXCEPT for: ...

    Incorrect

    • All of the following cause bronchodilation, EXCEPT for:

      Your Answer:

      Correct Answer: Stimulation of irritant receptors

      Explanation:

      Factors causing bronchodilation: Via beta2-adrenoceptors
      Sympathetic stimulation:
      Adrenaline (epinephrine)
      Beta2-adrenergic agonists e.g. salbutamol
      Anticholinergic and muscarinic antagonists e.g. ipratropium

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 29 - A 36-year-old man who works in a farm presents with a deep laceration...

    Incorrect

    • A 36-year-old man who works in a farm presents with a deep laceration over the palm of his hand. A median nerve block was performed at his wrist to facilitate wound exploration and closure.

      Which of the following statements regarding median nerve blocks at the wrist is considered correct?

      Your Answer:

      Correct Answer: The needle should be inserted approximately 2.5 cm proximal to flexor retinaculum

      Explanation:

      A median nerve block is a simple, safe, and effective method of obtaining anaesthesia to the palmar aspect of the thumb, index finger, middle finger, radial portion of the palm and ring finger. The median nerve lies deep to the flexor retinaculum and about one centimetre under the skin of the volar wrist.
      The palmaris longus tendon lies superficial to the retinaculum and is absent in up to 20% of patients.
      The median nerve is located slightly lateral (radial) to the palmaris longus tendon and medial (ulnar) to the flexor carpi radialis tendon.

      The procedure is as follows:
      – Check sensation and motor function of the median nerve. Wear gloves and use appropriate barrier precautions.
      – Locate the flexor carpi radialis and palmaris longus tendons, which become prominent when the patient flexes the wrist against resistance. The palmaris longus tendon is usually the more prominent of the two tendons.
      – Needle-entry site: The needle will be inserted adjacent to the radial (lateral) border of the palmaris longus tendon just proximal to the proximal wrist crease. If the palmaris longus tendon is absent, the needle-entry site is about 1 cm ulnar to the flexor carpi radialis tendon.
      – Cleanse the site with antiseptic solution. Place a skin wheal of anaesthetic, if one is being used, at the needle-entry site.
      – Insert the needle perpendicularly through the skin and advance it slowly until a slight pop is felt as the needle penetrates the flexor retinaculum. When paraesthesia in the distribution of the median nerve confirms proper needle placement, withdraw the needle 1 to 2 mm.
      – Aspirate to exclude intravascular placement and then slowly (i.e., over 30 to 60 seconds) inject about 3 mL of anaesthetic. If the patient does not feel paraesthesia, redirect the needle in an ulnar direction, under the palmaris longus tendon. If paraesthesia is still not felt, slowly inject 3 to 5 mL of anaesthetic in the proximity of the nerve 1 cm deep to the tendon.
      – Allow about 5 to 10 minutes for the anaesthetic to take effect.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 30 - A 53-year-old male has presented to your clinic with the complaint of a...

    Incorrect

    • A 53-year-old male has presented to your clinic with the complaint of a rash on his right forearm. On examination, you discover small reddish-purple spots on the skin measuring less than 2-3 mm. They do not blanch on applying pressure.

      Which one of the following best fits the description given above?

      Your Answer:

      Correct Answer: Petechiae

      Explanation:

      Petechiae are small red or purple spots on the skin measuring less than 3 mm, caused by minor haemorrhages which do not blanch on applying pressure.
      Purpura measures between 3mm and 1 cm in diameter, while ecchymoses are greater than 1 cm in diameter. Both are caused due to haemorrhage.

      Erythema is the generalised redness of the skin.

      A macule is a flat, discoloured area of the skin measuring less than 1 cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General Pathology (3/3) 100%
Pathology (4/4) 100%
Microbiology (4/5) 80%
Principles Of Microbiology (1/1) 100%
Physiology (7/9) 78%
Renal Physiology (1/1) 100%
Endocrine (2/2) 100%
Specific Pathogen Groups (2/2) 100%
Respiratory (1/3) 33%
Anaesthesia (1/1) 100%
Pharmacology (3/5) 60%
Central Nervous System (0/1) 0%
Infections (1/1) 100%
Gastrointestinal (1/2) 50%
Pathogens (1/2) 50%
Anatomy (2/2) 100%
Lower Limb (2/2) 100%
Respiratory Physiology (1/1) 100%
Cardiovascular (1/1) 100%
Musculoskeletal Pharmacology (1/1) 100%
Evidence Based Medicine (0/1) 0%
Haematology (1/1) 100%
Passmed