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Question 1
Correct
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Regarding acute lymphoblastic leukaemia (ALL), which of the following statements is CORRECT:
Your Answer: 75% of cases occur before the age of 6 years.
Explanation:Acute lymphoblastic leukaemia (ALL) is caused by an accumulation of lymphoblasts in the bone marrow and is the most common malignancy of childhood. The incidence of ALL is highest at 3 – 7 years, with 75% of cases occurring before the age of 6. 85% of cases are of B-cell lineage. Haematological investigations reveal a normochromic normocytic anaemia with thrombocytopenia in most cases. There is great variation in the chance of individual patients achieving a long-term cure based on a number of biological variables. Approximately 25% of children relapse after first-line therapy and need further treatment but overall 90% of children can expect to be cured. The cure rate in adults drops significantly to less than 5% over the age of 70 years.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 2
Correct
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Glucagon is the main catabolic hormone of the body and raises the concentration of glucose and fat in the bloodstream.
Which pancreatic islet cells secretes glucagon?Your Answer: Alpha
Explanation:Glucagon, secreted from the pancreatic islet alpha cells, is considered to be the main catabolic hormone of the body. It raises the concentration of glucose and fat in the bloodstream
There are five different pancreatic islet cells:
Alpha cells (20%) – produce glucagon
Beta cells (70%) – produce insulin and amylin
Delta cells (<10%) – produce somatostatin
Gamma cells (<5%) – produce pancreatic polypeptide
Epsilon cells (<1%) – produce ghrelin -
This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 3
Incorrect
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All of the following statements are correct with regards to protection of the gastric mucosa except which of the following?
Your Answer: IgA secretion prevents against invasion by ingested organisms.
Correct Answer: NSAIDs directly stimulate increased parietal cell acid production.
Explanation:Prostaglandin production, which usually inhibits acid secretion and increases mucus and bicarbonate secretion, is inhibited by NSAIDs.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 4
Correct
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All of the following predisposes to lithium toxicity in patients taking long-term therapy EXCEPT:
Your Answer: Hypernatraemia
Explanation:A common complication of long term lithium therapy results in most cases of lithium intoxication. It is caused by reduced excretion of the drug which can be due to several factors including deterioration of renal function, dehydration, hyponatraemia, infections, and co-administration of diuretics or NSAIDs or other drugs that may interact.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 5
Incorrect
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Nifedipine commonly causes which of the following adverse effects?
Your Answer: Bradycardia
Correct Answer: Ankle oedema
Explanation:Most common adverse effects of Nifedipine include:
Peripheral oedema (10-30%)
Dizziness (23-27%)
Flushing (23-27%)
Headache (10-23%)
Heartburn (11%)
Nausea (11%) -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 6
Incorrect
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You are attending to a patient that has presented with a severe headache in the Emergency Department. The patient has signs of cerebral oedema and raised intracranial pressure.
You discuss the case with the on-call neurology registrar and decide to prescribe Mannitol. The nurse assisting you asks you to reconsider this management plan as she suspects the patient has a contraindication to Mannitol.
Out of the following, what is a contraindication to mannitol?Your Answer: Polyuria
Correct Answer: Severe cardiac failure
Explanation:Mannitol is the most widely used osmotic diuretic that is most commonly used to reduce cerebral oedema and intracranial pressure.
It is recommended to use mannitol for the reduction of CSF pressure/cerebral oedema in a dose of 0.25-2 g/kg as an intravenous infusion over 30-60 minutes. This can be repeated 1-2 times after 4-8 hours if needed.Mannitol has several contraindications and some of them are listed below:
1. Anuria due to renal disease
2. Acute intracranial bleeding (except during craniotomy)
3. Severe cardiac failure
4. Severe dehydration
5. Severe pulmonary oedema or congestion
6. Known hypersensitivity to mannitol -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 7
Incorrect
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Which of the following movements is controlled by the pectoralis major muscle?
Your Answer: Extension, adduction and medial rotation of the humerus
Correct Answer: Flexion, adduction and medial rotation of the humerus
Explanation:The pectoralis major is a muscle that runs across the top of the chest and connects to a ridge on the back of the humerus (the bone of the upper arm).
Adduction, or lowering, of the arm (opposed to the deltoideus muscle) and rotation of the arm forward around the axis of the body are two of its main functions.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 8
Incorrect
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Which of the following is NOT a typical feature of an abducens nerve palsy:
Your Answer: Horizontal diplopia
Correct Answer: Inability to look up
Explanation:CN VI palsies result in a convergent squint at rest (eye turned inwards) with inability to abduct the eye because of unopposed action of the rectus medialis. The patient complains of horizontal diplopia when looking towards the affected side. With complete paralysis, the eye cannot abduct past the midline.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 9
Incorrect
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A 47-year-old woman comes in with palpitations that have been bothering her for the past four days. Her haemodynamics are normal, but her heart rate is currently 150 beats per minute. An ECG is performed, which reveals that she is experiencing atrial flutter. The patient is examined by a cardiology registrar, who recommends starting her on verapamil to control her ventricular rate while she waits for cardioversion.
In these circumstances, which of the following is a contraindication to the use of verapamil?Your Answer: Aortic stenosis
Correct Answer: Acute porphyria
Explanation:In most cases of atrial flutter, ventricular rate control is used as a stopgap measure until sinus rhythm is restored. A beta-blocker (e.g. bisoprolol), diltiazem, or verapamil can be used to reduce the rate of contractions in the heart.
Electrical cardioversion, pharmacological cardioversion, and catheter ablation can all be used to return the heart to a normal rhythm. Cardioversion should not be attempted until the patient has been fully anticoagulated for at least three weeks if the duration of atrial flutter is unknown or it has lasted longer than 48 hours. Emergency electrical cardioversion is the treatment of choice when there is a sudden onset of symptoms and haemodynamic compromise. For recurrent atrial flutter, catheter ablation is preferred.Verapamil is a calcium-channel blocker that is non-dihydropyridine phenylalkylamine and can be used to treat supraventricular arrhythmias. It’s a calcium channel blocker with a high negative inotropic effect that lowers cardiac output, slows the heart rate, and may impair atrioventricular conduction. At high doses, it can cause heart failure, exacerbate conduction disorders, and cause hypotension.
Adults should take 240-480 mg of verapamil in 2-3 divided doses. 5-10 mg IV over 30 seconds is the corresponding intravenous (IV) dose. After an IV injection, the peak effect lasts 3-5 minutes, and the action lasts 10-20 minutes.
Verapamil should not be taken with beta-blockers like atenolol or quinidine because the combination of their negatively inotropic and negatively chronotropic effects can result in severe hypotension, bradycardia, impaired atrioventricular conduction, heart failure (due to impaired cardiac contractility), and sinus arrest.
The use of verapamil is contraindicated in the following situations:
Acute porphyrias are a type of porphyria that occurs suddenly.
Accessory conducting pathways are linked to atrial flutter or fibrillation (e.g. Wolff-Parkinson-White-syndrome)
Bradycardia
Shock caused by the heart
Insufficiency of the heart (with reduced ejection fraction)
Left ventricular function has been significantly harmed in the past (even if controlled by therapy)
Hypotension (blood pressure less than 90 mmHg)
AV block in the second and third degrees
Sinusitis is a condition in which the sinuses become
Sino-atrial occlusion -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 10
Incorrect
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Bile acids are essential for the digestion and absorption of which of the following:
Your Answer: Vitamin B12
Correct Answer: Lipids and fat-soluble vitamins
Explanation:Bile acids are synthesised from cholesterol by hepatocyte and excreted into bile. Bile acids are essential for lipid digestion and absorption. Of the bile acids excreted into the intestine, about 95% are reabsorbed into the portal circulation by active transport mechanisms in the distal ileum and recycled by the liver. Many of the bile salts are reabsorbed unaltered, some are converted by intestinal bacteria into secondary bile acids (deoxycholic acid and lithocholic acid) and then reabsorbed and a small proportion escapes reabsorption and is excreted in the faeces.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 11
Correct
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Lidocaine's antiarrhythmic mode of action is as follows:
Your Answer: Blocks inactivated Na+ channels
Explanation:Lidocaine is a class 1B antidysrhythmic; combines with fast Na channels and thereby inhibits recovery after repolarization, resulting in decreasing myocardial excitability and conduction velocity. However, in ischaemic areas, where anoxia causes depolarisation and arrhythmogenic activity, many Na+ channels are inactivated and therefore susceptible to lidocaine.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 12
Correct
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All of the following are actions of insulin except:
Your Answer: Increased gluconeogenesis
Explanation:Major Actions of Insulin:
↑ Glucose uptake into cells
↑ Glycogenesis
↓ Glycogenolysis
↓ Gluconeogenesis
↑ Protein synthesis
↓ Protein degradation
↑ Fat deposition
↓ Lipolysis
↓ Ketoacid production
↑ K+ uptake into cellsMajor Actions of Glucagon:
↓ Glycogenesis
↑ Glycogenolysis
↑ Gluconeogenesis
↓ Fatty acid synthesis
↑ Lipolysis
↑ Ketoacid production -
This question is part of the following fields:
- Endocrine
- Physiology
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Question 13
Correct
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A patient allergic to penicillin and with marked cellulitis presents and you decide to start him on erythromycin.
Which statement about macrolide antibiotics is true?
Your Answer: They are actively concentrated within leukocytes
Explanation:Macrolide antibiotics are bacteriostatic.
They act by binding to the 50S subunit of the bacterial ribosome inhibit protein synthesis.
Macrolide antibiotics are actively concentrated within leukocytes, because of this, they are transported into the site of infection.
Macrolide antibiotics are not effective in meningitis as they do not penetrate the central nervous system well.
They are mainly against Gram-positive organisms and can be used as an alternative in patients with penicillin allergy.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 14
Correct
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You're in resus with a 69-year-old woman who is very sick. You decide to contact the intensive care outreach team because she appears to be in septic shock. They decide to start a dobutamine infusion as soon as they arrive.
Which of the following statements about dobutamine is correct?Your Answer: It may be infused via a peripheral line
Explanation:Dobutamine is a synthetic isoprenaline derivative that is used to provide inotropic support to patients with low cardiac output caused by septic shock, myocardial infarction, or other cardiac conditions.
Dobutamine is a sympathomimetic drug that stimulates beta-1 adrenergic receptors in the heart to produce its primary effect. As a result, it has inotropic properties that increase cardiac contractility and output. It also has a small amount of alpha1- and beta-2-adrenergic activity.
It is infused intravenously after being diluted to a volume of at least 50 ml in a suitable crystalloid solution. The dose is titrated to response and ranges from 0.5 to 40 g/kg/min. Extravasation-induced skin necrosis is uncommon, and dobutamine can be administered through a peripheral line.
At doses below 10 g/kg/min, side effects are rare, but at higher doses, they can include:
Nausea and vomiting
Tachycardia
Dysrhythmias
Angina
Hypertension
Headache -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 15
Correct
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A 25 year old man presents to the emergency room with abdominal pain, vomiting and constipation. A CT scan is done which is suggestive of Meckel's diverticulum. Where does the blood supply of the Meckel's diverticulum originate?
Your Answer: Superior mesenteric artery
Explanation:Meckel’s diverticulum has certain classic characteristics.
1. It lies on the antimesenteric border of the middle-to-distal ileum
2. It is approximately 2 feet proximal to the ileocaecal junction
3. It appears as a blind-ended tubular outpouching of bowel
4. It is about 2 inches long,
5. It occurs in about 2% of the population,
6. It may contain two types of ectopic tissue (gastric and pancreatic).
7. The diverticulum is supplied by the superior mesenteric artery.
8. Proximal to the major duodenal papilla the duodenum is supplied by the gastroduodenal artery (branch of the coeliac trunk)
9. Distal to the major duodenal papilla it is supplied by the inferior pancreaticoduodenal artery (branch of superior mesenteric artery).
10. The arterial supply to the jejunoileum is from the superior mesenteric artery. -
This question is part of the following fields:
- Abdomen
- Anatomy
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Question 16
Correct
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A 22-year-old woman is brought in by ambulance from her GP surgery with suspected meningitis. She has been given a dose of benzylpenicillin already.
What is the mechanism of action of benzylpenicillin? Select ONE answer only.Your Answer: Inhibition of cell wall synthesis
Explanation:Penicillins and the other ß-lactam antibiotics are bactericidal. They produce their antimicrobial action by preventing cross-linkage between the linear peptidoglycan polymer chains that make up the bacterial cell wall. They, therefore, inhibit cell wall synthesis.
An overview of the different mechanisms of action of the various types of antimicrobial agents is shown below:
Mechanism of action
Examples
Inhibition of cell wall synthesis
Penicillins
Cephalosporins
Vancomycin
Disruption of cell membrane function
Polymyxins
Nystatin
Amphotericin B
Inhibition of protein synthesis
Macrolides
Aminoglycosides
Tetracyclines
Chloramphenicol
Inhibition of nucleic acid synthesis
Quinolones
Trimethoprim
5-nitroimidazoles
Rifampicin
Anti-metabolic activity
Sulfonamides
Isoniazid -
This question is part of the following fields:
- Infections
- Pharmacology
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Question 17
Incorrect
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Which of the following is NOT a typical effect of cortisol:
Your Answer: Increased lipolysis
Correct Answer: Decreased protein catabolism
Explanation:Cortisol is a steroid hormone produced in the zona fasciculata of the adrenal cortex. It is released in response to stress and low blood glucose concentrations.
Cortisol acts to: raise plasma glucose by stimulating glycolysis and gluconeogenesis in the liver and inhibiting peripheral glucose uptake into storage tissues, increase protein breakdown in skeletal muscle, skin and bone to release amino acids, increase lipolysis from adipose tissues to release fatty acidsand at higher levels and mimic the actions of aldosterone on the kidney to retain Na+ and water and lose K+ ionssuppress the action of immune cells -
This question is part of the following fields:
- Endocrine
- Physiology
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Question 18
Incorrect
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All of the following statements is considered true regarding Streptococcus pneumoniae, except:
Your Answer: Many strains are now resistant to penicillins
Correct Answer: It is the commonest cause of erysipelas
Explanation:Erysipelas is a rare infection of the skin and subcutaneous tissues observed frequently in elderly patients. It is characterized by an acute spreading skin lesion that is intensely erythematous with a plainly demarcated but irregular edge. It is most commonly caused by Streptococcus pyogenes or Group A Streptococcus (GAS).
GAS are susceptible to penicillin, which remains the drug of choice for treatment. For patients allergic to penicillin, erythromycin can be used.
S. pyogenes colonizes the throat and skin on humans, making these sites the primary sources of transmission. Infections resulting from S. pyogenes include pharyngitis, scarlet fever, skin or pyodermal infections, and other septic infections. In addition, the sequelae rheumatic fever and acute glomerulonephritis can occur as a result of infection with S. pyogenes.
Agammaglobulinemia is mostly associated with S. pneumoniae.
The M protein is attached to the peptidoglycan of the cell wall and extends to
the cell surface. The M protein is essential for virulence. The polysaccharide capsule is characteristic of S. pneumoniae. -
This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 19
Incorrect
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Which of the following nerves innervates the gastrocnemius muscle?
Your Answer: Sciatic nerve
Correct Answer: Tibial nerve
Explanation:The gastrocnemius is innervated by the anterior rami of S1 and S2 spinal nerves, carried by the tibial nerve into the posterior compartment of the leg.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 20
Incorrect
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A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck.
Which of the following muscles is LEAST likely to be involved? Select ONE answer only.Your Answer: Anterior scalene
Correct Answer: Sternohyoid
Explanation:The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains:
Muscles: thyrohyoid, sternothyroid, sternohyoid muscles
Organs: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid gland
Arteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteries
Veins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veins
Nerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerveThe posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle.
Contents:
Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodes
Nerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexus -
This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 21
Incorrect
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Which of the following is an example of discrete data:
Your Answer: Disease staging system
Correct Answer: Number of children
Explanation:Discrete data is quantitative data that can only take whole numerical values e.g. number of children, number of days missed from work.
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 22
Correct
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A 25-year-old athlete suffers an injury to the nerve that innervates the gluteus minimus muscle.
Which of the following nerves innervates the gluteus minimus muscle?Your Answer: Superior gluteal nerve
Explanation:Gluteus minimus is the smallest muscle of the glutei. It is located just beneath the gluteus medius muscle. Gluteus minimus predominantly acts as a hip stabilizer and abductor of the hip.
The superior gluteal nerve innervates the gluteus minimus. -
This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 23
Incorrect
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All of the following statements are considered true regarding likelihood ratios, except:
Your Answer: The likelihood ratio for a negative test = (1-sensitivity) / specificity
Correct Answer: If less than one, indicates that the information increases the likelihood of the suspected diagnosis
Explanation:The Likelihood Ratio (LR) is the likelihood that a given test result would be expected in a patient with the target disorder compared to the likelihood that that same result would be expected in a patient without the target disorder.
The LR is used to assess how good a diagnostic test is and to help in selecting an appropriate diagnostic tests or sequence of tests. They have advantages over sensitivity and specificity because they are less likely to change with the prevalence of the disorder, they can be calculated for several levels of the symptom/sign or test, they can be used to combine the results of multiple diagnostic test and they can be used to calculate post-test probability for a target disorder.
A LR greater than 1 produces a post-test probability which is higher than the pre-test probability. An LR less than 1 produces a post-test probability which is lower than the pre-test probability. When the pre-test probability lies between 30 and 70 per cent, test results with a very high LR (say, above 10) rule in disease. An LR below 1 produces a post-test probability les than the pre-test probability. A very low LR (say, below 0.1) virtually rules out the chance that the patient has the disease.
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This question is part of the following fields:
- Evidence Based Medicine
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Question 24
Incorrect
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A 43-year old male is taken to the Emergency Room for a lacerated wound on the abdomen, situated above the umbilicus. A short segment of the small bowel has herniated through the wound.
Which of these anatomic structures is the most superficial structure injured in the case above?Your Answer: Scarpa’s fascia
Correct Answer: Camper’s fascia
Explanation:The following structures are the layers of the anterior abdominal wall from the most superficial to the deepest layer:
Skin
Fatty layer of the superficial fascia (Camper’s fascia)
Membranous layer of the superficial fascia (Scarpa’s fascia)
Aponeurosis of the external and internal oblique muscles
Rectus abdominis muscle
Aponeurosis of the internal oblique and transversus abdominis
Fascia transversalis
Extraperitoneal fat
Parietal peritoneum -
This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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Question 25
Incorrect
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Which of the following statements accurately describes the extensor indicis muscle?
Your Answer: It is innervated by the median nerve
Correct Answer: It lacks the juncturae tendinum
Explanation:Extensor indicis is a narrow, elongated muscle found in the posterior compartment of the forearm. It belongs to the deep extensors of the forearm, together with supinator, abductor pollicis longus, extensor pollicis longus, and extensor pollicis brevis muscles. It lacks the juncturae tendinum, which connects the extensor digitorum on the dorsal aspect of the hand.
Extensor indicis can be palpated by applying deep pressure over the lower part of the ulna while the index finger is extended. The main function of extensor indicis involves the extension of the index finger at the metacarpophalangeal and interphalangeal joints. As the index finger is one of the few fingers that have their own separate extensor muscle, it is able to extend independently from other fingers. Additionally, extensor indicis muscle produces a weak extension of the wrist.
Extensor indicis receives its nervous supply from posterior interosseous nerve, a branch of the radial nerve derived from spinal roots C7 and C8. The skin overlying the muscle is supplied by the same nerve, with fibres that stem from the spinal roots C6 and C7.
The superficial surface of the extensor indicis receives arterial blood supply from posterior interosseous branch of the ulnar artery, whereas its deep surface receives blood from perforating branches of the anterior interosseous artery.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 26
Incorrect
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An increased anion gap metabolic acidosis is typically caused by which of the following?
Your Answer: Chronic diarrhoea
Correct Answer: Propylene glycol overdose
Explanation:Causes of a raised anion gap acidosis can be remember using the mnemonic MUDPILES:
-Methanol
-Uraemia (in renal failure)
-Diabetic ketoacidosis
-Propylene glycol overdose
-Infection/Iron overdose/Isoniazid/Inborn errors of metabolism
-Lactic acidosis
-Ethylene glycol overdose
-Salicylate overdose -
This question is part of the following fields:
- Physiology
- Renal
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Question 27
Correct
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Regarding cortical areas, which one is found in the posterior part of the inferior frontal gyrus?
Your Answer: Broca’s area
Explanation:Broca’s area is involved in the expressive aspects of spoken and written language (production of sentences constrained by the rules of grammar and syntax). It corresponds to the opercular and triangular parts of the inferior frontal gyrus (BA 44 and 45). These areas are defined by two rami (branches) of the lateral sulcus (one ascending, one horizontal) which ‘slice into’ the inferior frontal gyrus. In keeping with its role in speech and language, Broca’s area is immediately anterior to the motor and premotor representations of the face, tongue and larynx. A homologous area in the opposite hemisphere is involved in non-verbal communication such as facial expression, gesticulation and modulation of the rate, rhythm and intonation of speech.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 28
Incorrect
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Regarding haemophilia A, which of the following statements is INCORRECT:
Your Answer: Haemophilia A is caused by a deficiency of factor VIII.
Correct Answer: In haemophilia both the APTT and PT are prolonged.
Explanation:Haemophilia A is the most common of the hereditary clotting factor deficiencies. The inheritance is sex-linked but up to one-third of patients have no family history and these cases result from recent mutation. The vast majority of cases are inherited in an X-linked recessive fashion, affecting males born to carrier mothers. Females born to affected fathers can also, rarely, be affected due to homozygosity for the gene, where there is marriage to close relatives.
The defect is an absence or low level of plasma factor VIII. The APTT is prolonged but the PT is normal. Recurrent painful haemarthroses and muscle haematomas dominate the clinical course of severely affected patients and if inadequately treated, lead to progressive joint deformity and disability. Local pressure can cause entrapment neuropathy or ischaemic necrosis. Prolonged bleeding occurs after dental extractions or post-trauma. Spontaneous haematuria and gastrointestinal haemorrhage may occur. The clinical severity of the disease correlates inversely with the factor VIII level. Operative and post-traumatic haemorrhage are life-threatening both in severely and mildly affected patients.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 29
Correct
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A patient with pronounced tremor, muscle contractions, muscle spasms, and slowness of movement is brought in by his family. He has a long history of mental health issues for which he is currently treated with a variety of medications.
Which of the medications listed below is most likely to be the cause of these side effects?Your Answer: Haloperidol
Explanation:Acute dyskinesias and dystonic reactions, tardive dyskinesia (rhythmic, involuntary movements of the tongue, face, and jaw), Parkinsonism (tremor, bradykinesia, and rigidity), akinesia, akathisia, and neuroleptic malignant syndrome are all examples of extrapyramidal side effects. They are caused by dopamine depletion or blockade in the basal ganglia; this lack of dopamine frequently mimics idiopathic extrapyramidal pathologies.
The first-generation antipsychotics, which are strong dopamine D2 receptor antagonists, are the drugs most commonly associated with extrapyramidal side effects. Haloperidol and fluphenazine are the two drugs in this class that are most commonly associated with extrapyramidal side effects. Extrapyramidal adverse effects are less common in second-generation antipsychotics (e.g., olanzapine) than in first-generation antipsychotics.
Other drugs are linked to extrapyramidal symptoms as well, but at a lower rate. Some antidepressants, lithium, various anticonvulsants, antiemetics, and, in rare cases, oral contraceptive agents are among them.
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 30
Incorrect
SESSION STATS - PERFORMANCE PER SPECIALTY
