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  • Question 1 - Which of these structures is the smallest and deepest component of...

    Incorrect

    • Which of these structures is the smallest and deepest component of muscle connective tissue?

      Your Answer: Fascicle

      Correct Answer: Endomysium

      Explanation:

      There are three types of muscle:
      Skeletal muscle
      Cardiac muscle
      Smooth muscle

      Individual muscle is enveloped in a layer of dense irregular connective tissue called the epimysium. The epimysium protects the muscles from friction against bones and other muscles.

      Skeletal muscle is composed of muscle fibres, referred to as myofibers which is ensheathed by a wispy layer of areolar connective tissue called the endomysium. The endomysium is the smallest and deepest component of muscle connective tissue.

      Myofibers grouped together in bundles form fascicles, or fasciculi. These are surrounded by a type of connective tissue called the perimysium.

      Beneath the endomysium lies the sarcolemma, an elastic sheath with infoldings that invaginate the interior of the myofibers, particularly at the motor endplate of the neuromuscular junction.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      45.5
      Seconds

  • Question 2 - An analytical study is conducted to compare the risk of stroke between Ticagrelor...

    Incorrect

    • An analytical study is conducted to compare the risk of stroke between Ticagrelor therapy and Warfarin therapy among patients with atrial fibrillation. The following is obtained from the study:

      No. of patients who took Ticagrelor: 300
      No. of patients who took Ticagrelor and suffered a stroke: 30

      No. of patients who took Warfarin: 500
      No. of patients who took Warfarin and suffered a stroke: 20

      Compute for the risk ratio of a stroke.

      Your Answer: 0.4

      Correct Answer: 2.5

      Explanation:

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

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

      RR = ART/ARC
      RR = (30/300) / (20/500)
      RR = 2.5

      Recall that:

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

    • This question is part of the following fields:

      • Evidence Based Medicine
      10.8
      Seconds

  • Question 3 - Regarding beta-thalassaemia, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding beta-thalassaemia, which of the following statements is CORRECT:

      Your Answer: The anaemia of beta-thalassaemia major is usually apparent from birth.

      Correct Answer: Beta-thalassaemia trait is associated with a raised HbA2.

      Explanation:

      Beta-thalassaemia major is caused by a complete or almost complete failure of β-globin chain synthesis, severe imbalance of α:β-chains with deposition of α-chains in erythroblasts, ineffective erythropoiesis and extramedullary haemopoiesis. The severe anaemia becomes apparent at 3 – 6 months when the switch from γ-chain to β-chain synthesis normally occurs. Beta-thalassaemia minor is a variable syndrome, milder than thalassaemia major, with later onset and characterised by moderate hypochromic microcytic anaemia with raised haemoglobin A2. Beta-thalassaemia trait is characterised by mild hypochromic, microcytic anaemia with raised red cell count and raised haemoglobin A2.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      9.3
      Seconds

  • Question 4 - Urine flow rate = 2 ml/min
    Urine concentration of creatinine = 18 mg/ml
    Plasma...

    Incorrect

    • Urine flow rate = 2 ml/min
      Urine concentration of creatinine = 18 mg/ml
      Plasma concentration of creatinine = 0.25 mg/ml

      What is the estimated glomerular filtration rate (eGFR)?

      Your Answer: 2.5 ml/min

      Correct Answer: 144 ml/min

      Explanation:

      GFR can be estimated by:
      GFR = UCr x V / PCr
      Where:
      UCr = urine concentration of creatinine
      PCr = plasma concentration of creatinine
      V = rate of urine flow

      In this case GFR = (18 x 2) / 0.25 = 144 ml/min

      Note: Creatinine is used to estimate GFR because it is an organic base naturally produced by muscle breakdown, it is freely filtered at the glomerulus, it is not reabsorbed from the nephron, it is not produced by the kidney, it is not toxic, and it doesn’t alter GFR.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      11.5
      Seconds

  • Question 5 - Which of the following statements is false regarding the biceps brachii muscle? ...

    Incorrect

    • Which of the following statements is false regarding the biceps brachii muscle?

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

      Correct Answer: It pronates the radioulnar joint in the forearm

      Explanation:

      The biceps brachii muscle is one of the chief muscles of the arm. The origin at the scapula and the insertion into the radius of the biceps brachii means it can act on both the shoulder joint and the elbow joint, which is why this muscle participates in a few movements of the arm. It derives its name from its two heads which merge in one unique distal body, defining the unusual structure of the muscle.

      The biceps brachii muscle is supplied by the musculocutaneous nerve (C5-C6), a branch of the brachial plexus.

      Arterial supply to the biceps brachii muscle varies considerably, coming from up to eight vessels originating from the brachial artery in the middle third of the arm.

      In the shoulder joint both muscle heads partially enforce opposite movements. The long head pulls the arm away from the trunk (abduction) and turns it inwards (inward rotation) whereas the short head pulls the arm back towards the trunk (adduction). When both heads contract simultaneously it leads to an arm bend (flexion). In the elbow joint the muscle bends the forearm (flexion) and rotates it outwards (supination). The supination is most powerful in a flexed elbow. In addition to the movement functions, the biceps has the important task to support the humeral head within the shoulder joint. Its antagonist is the triceps brachii in the posterior compartment of the arm.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      5.3
      Seconds

  • Question 6 - Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or...

    Incorrect

    • Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or rectosigmoid should be treated initially with:

      Your Answer: Oral aminosalicylate

      Correct Answer: Local aminosalicylate

      Explanation:

      Acute mild to moderate disease affecting the rectum (proctitis) or the rectosigmoid is treated initially with local application of an aminosalicylate; alternatively, a local corticosteroid can be used but it is less effective. A combination of a local aminosalicylate and a local corticosteroid can be used for proctitis that does not respond to a local aminosalicylate alone.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      18.3
      Seconds

  • Question 7 - A 32-year-old asthmatic patient on theophylline as part of her asthma management...

    Correct

    • A 32-year-old asthmatic patient on theophylline as part of her asthma management presents to the Emergency Department with an unrelated medical condition.

      Which of these drugs should be avoided?

      Your Answer: Clarithromycin

      Explanation:

      Macrolide antibiotics (e.g. clarithromycin and erythromycin) are cytochrome P450 enzyme inhibitors. They increase blood levels of theophylline leading to hypokalaemia, and potentially increasing the risk of Torsades de pointes when they are prescribed together.

      Co-prescription with theophylline should be avoided.

      Factors that enhance theophylline clearance include cigarette smoking, carbamazepine, phenobarbital, phenytoin, primidone, and rifampin.
      Medications that inhibit clearance include ethanol, ciprofloxacin, erythromycin, verapamil, propranolol, ticlopidine, tacrine, allopurinol, and cimetidine.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      16.4
      Seconds

  • Question 8 - 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: Hypotension alone

      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
      7.6
      Seconds

  • Question 9 - Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT:

      Your Answer: Factors that affect intracellular [Ca 2+ ] and hence cardiac contractility are called chronotropes.

      Correct Answer: In relaxation, Ca 2+ is transported out of the cell using energy from a Na + gradient.

      Explanation:

      During the AP plateau, Ca2+enters the cell and activates Ca2+sensitive Ca2+release channels in the sarcoplasmic reticulum allowing stored Ca2+to flood into the cytosol; this is called Ca2+-induced Ca2+release. In relaxation, about 80% of Ca2+is rapidly pumped back into the SR (sequestered) by Ca2+ATPase pumps. The Ca2+that entered the cell during the AP is transported out of the cell primarily by the Na+/Ca2+exchanger in the membrane which pumps one Ca2+ion out in exchange for three Na+ions in, using the Na+electrochemical gradient as an energy source. Increased heart rate increases the force of contraction in a stepwise fashion as intracellular [Ca2+] increases cumulatively over several beats; this is the Treppe effect. Factors that affect intracellular [Ca2+] and hence cardiac contractility are called inotropes.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      21.9
      Seconds

  • Question 10 - A 23-year-old female has been prescribed a medication in the first trimester of...

    Incorrect

    • A 23-year-old female has been prescribed a medication in the first trimester of pregnancy due to a life-threatening medical problem. After delivery, the foetus is found to have nasal hypoplasia, stippling of his bones and atrophy of bilateral optic discs along with growth retardation.

      Which ONE of the following drugs has this woman most likely received?

      Your Answer: Chloramphenicol

      Correct Answer: Warfarin

      Explanation:

      Warfarin is teratogenic and can cause a host of abnormalities in the growing foetus. These include hypoplasia of the nasal bridge, stippling of the epiphyses, multiple ophthalmic complications, growth retardation, pectus carinatum, atrial septal defect, ventriculomegaly and a patent ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      11
      Seconds

  • Question 11 - A 32 year old woman presents with episodes of flushing, headaches and palpitations....

    Incorrect

    • 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:

      Correct 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
      0
      Seconds

  • Question 12 - You're in resus with a 69-year-old woman who is very sick. You decide...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds

  • Question 13 - The fluid in contact with a tube is dragged by frictional forces to...

    Incorrect

    • The fluid in contact with a tube is dragged by frictional forces to the tube's sidewalls. This creates a velocity gradient in which the fluid flow is greatest in the tube's centre.

      Which of the following terms most accurately characterizes this flow pattern?

      Your Answer:

      Correct Answer: Laminar flow

      Explanation:

      The fluid in contact with a tube is dragged by frictional forces at the tube’s sidewalls. This creates a velocity gradient in which the fluid flow is greatest in the tube’s centre.
      This is known as laminar flow, and it characterizes the flow in most circulatory and respiratory systems when they are at rest.

      The velocity of the fluid flow can fluctuate erratically at high velocities, particularly within big arteries and airways, disrupting laminar flow. As a result, resistance increases significantly.
      This is known as turbulent flow, and symptoms include heart murmurs and asthmatic wheeze.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      0
      Seconds

  • Question 14 - Glucagon is contraindicated in which of the following: ...

    Incorrect

    • Glucagon is contraindicated in which of the following:

      Your Answer:

      Correct Answer: Pheochromocytoma

      Explanation:

      Glucagon is contraindicated in pheochromocytoma.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      0
      Seconds

  • Question 15 - Angiotensin II acts to cause all but which one of the following effects:...

    Incorrect

    • Angiotensin II acts to cause all but which one of the following effects:

      Your Answer:

      Correct Answer: Inhibit release of ADH from the posterior pituitary gland

      Explanation:

      Angiotensin II acts to:
      Stimulate release of aldosterone from the zona glomerulosa of the adrenal cortex (which in turn acts to increase sodium reabsorption)
      Cause systemic vasoconstriction
      Cause vasoconstriction of the renal arterioles (predominant efferent effect thus intraglomerular pressure is stable or increased, thereby tending to maintain or even raise the GFR)
      Directly increase Na+reabsorption from the proximal tubule (by activating Na+/H+antiporters)
      Stimulate synthesis and release of ADH from the hypothalamus and posterior pituitary respectively
      Stimulate the sensation of thirst
      Potentiate sympathetic activity (positive feedback)
      Inhibit renin production by granular cells (negative feedback)

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 16 - Which of the following is the most likely causative organism of acute epiglottitis...

    Incorrect

    • Which of the following is the most likely causative organism of acute epiglottitis in a 6 year old?

      Your Answer:

      Correct Answer: Streptococcus pneumoniae

      Explanation:

      Since the introduction of the HIB vaccine, most cases of acute epiglottitis are now caused by Streptococcus spp. The condition is now rare in children.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 17 - Na+ is reabsorbed via the Na+/K+/2Cl-symporter in which part of the loop of...

    Incorrect

    • Na+ is reabsorbed via the Na+/K+/2Cl-symporter in which part of the loop of Henle?

      Your Answer:

      Correct Answer: Thick ascending limb

      Explanation:

      In the thick ascending limb is the part of the loop of Henle in which there is active reabsorption of Na+and Cl- ions from the tubular fluid. This occurs via the Na+/K+/2Cl-symporter on the apical membrane.
      This mechanism is by:
      1. Na+ions are transported across the basolateral membrane by Na+pumps and the Cl-ions by diffusion.
      2. K+leaks back into the tubular fluid via apical ROMK K+channels which creates a positive charge.
      3. This positive charge drives the reabsorption of cations (Na+, K+, Ca2+, Mg2+) through paracellular pathways.
      4. Due to the thick ascending limb being impermeable to water, the tubular fluid osmolality is reduced by ion reabsorption, the interstitial fluid osmolality is increased, and an osmotic difference is created.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 18 - The renal corpuscle, consisting of the Bowman's capsule and the glomerulus is found...

    Incorrect

    • The renal corpuscle, consisting of the Bowman's capsule and the glomerulus is found where in the kidney:

      Your Answer:

      Correct Answer: The cortex

      Explanation:

      All nephrons have their renal corpuscles in the renal cortex. Cortical nephrons have their renal corpuscles in the outer part of the cortex and relatively short loops of Henle. Juxtamedullary nephrons have their corpuscles in the inner third of the cortex, close to the corticomedullary junction, with long loops of Henle extending into the renal medulla.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 19 - 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:

      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
      0
      Seconds

  • Question 20 - Noradrenaline exhibits its positive inotropic effect by which of the following mechanisms: ...

    Incorrect

    • Noradrenaline exhibits its positive inotropic effect by which of the following mechanisms:

      Your Answer:

      Correct Answer: Binds to beta1-receptors and causes increased Ca2+ entry via L-type channels during the action potential

      Explanation:

      Noradrenaline (the sympathetic neurotransmitter) is a positive inotrope; it binds to β1-adrenoceptors on the membrane and causes increased Ca2+entry via L-type channels during the AP and thus increases Ca2+release from the SR. Noradrenaline also increases Ca2+sequestration into the SR and thus more Ca2+is available for the next contraction. Cardiac glycosides (e.g. digoxin) slow the removal of Ca2+from the cell by inhibiting the membrane Na+pump which generates the Na+gradient required for driving the export of Ca2+; consequently the removal of Ca2+from the myocyte is slowed and more Ca2+is available for the next contraction. Acidosis is negatively inotropic, largely because H+competes for Ca2+binding sites.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 21 - A 32-year-old woman with a history of bipolar disorder exhibits lithium toxicity symptoms.

    Which...

    Incorrect

    • A 32-year-old woman with a history of bipolar disorder exhibits lithium toxicity symptoms.

      Which of the following is the MOST LIKELY feature to be present?

      Your Answer:

      Correct Answer: Clonus

      Explanation:

      Lithium toxicity manifests itself in the following ways:
      Ataxia
      Clonus
      Coma
      Confusion
      Convulsions
      Diarrhoea
      Increased muscle tone
      Nausea and vomiting
      Nephrogenic diabetes insipidus
      Renal failure
      Tremor

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 22 - The following statements are not true of the flexor digiti minimi brevis, except?...

    Incorrect

    • The following statements are not true of the flexor digiti minimi brevis, except?

      Your Answer:

      Correct Answer: It is situated on the radial border of abductor digiti minimi

      Explanation:

      Flexor digiti minimi brevis muscle is located on the ulnar side of the palm, lying on the radial border of the abductor digiti minimi. Together with the abductor digiti minimi and opponens digiti minimi muscles, it forms the hypothenar eminence. The muscle is situated inferior and lateral to adductor digiti minimi muscle and superior and medial to opponens digiti minimi muscle. The proximal parts of flexor digiti minimi brevis and abductor digiti minimi muscles form a gap through which deep branches of the ulnar artery and ulnar nerve pass.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 23 - Regarding skeletal muscle contraction, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding skeletal muscle contraction, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: The force of contraction of a muscle can be controlled by increasing recruitment of motor units.

      Explanation:

      Each motor unit contracts in an all or nothing fashion, i.e. if a motor unit is excited, it will stimulate all of its muscle fibres to contract. The force of contraction of a muscle is controlled by varying the motor unit recruitment (spatial summation), and by varying the firing rate of the motor units (temporal summation). During a gradual increase in contraction of a muscle, the first units start to discharge and increase their firing rate, and, as the force needs to increase, new units are recruited and, in turn, also increase their firing rate. For most motor units, the firing rate for a steady contraction is between 5 and 8 Hz. Because the unitary firing rates for each motor unit are different and not synchronised, the overall effect is a smooth force profile from the muscle. Increasing the firing rate of motor units is temporal summation where the tension developed by the first action potential has not completely decayed when the second action potential and twitch is grafted onto the first and so on. If the muscle fibres are stimulated repeatedly at a faster frequency, a sustained contraction results where it is not possible to detect individual twitches. This is called tetanus.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 24 - Which of the following tracts must be affected if a patient presents with...

    Incorrect

    • Which of the following tracts must be affected if a patient presents with decreased pain and temperature sensation in both lower extremities?

      Your Answer:

      Correct Answer: The lateral spinothalamic tract

      Explanation:

      The main function of the spinothalamic tract is to carry pain and temperature via the lateral part of the pathway and crude touch via the anterior part. The spinothalamic tract pathway is an imperative sensory pathway in human survival because it enables one to move away from noxious stimuli by carrying pain and temperature information from the skin to the thalamus where it is processed and transmitted to the primary sensory cortex. The primary sensory cortex communicates with the primary motor cortex, which lies close to it, to generate rapid movement in response to potentially harmful stimuli. Furthermore, the spinothalamic tract has a role in responding to pruritogens, causing us to itch. Interestingly, itching suppresses the spinothalamic tract neuron response to the histamine effect.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 25 - A 79-year-old male had a humeral shaft fracture during a road traffic accident...

    Incorrect

    • A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.

      All the following are responsible for this non-union EXCEPT?

      Your Answer:

      Correct Answer: Osteoporosis

      Explanation:

      An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected.

      Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds

  • Question 26 - A 22-year-old with a history of brittle asthma is brought to the ED...

    Incorrect

    • A 22-year-old with a history of brittle asthma is brought to the ED by her partner. She is wheezing and very short of breath and her condition is deteriorating rapidly. Following a series of nebulisations, hydrocortisone and IV magnesium sulphate, she is taken to resus and the intensive care team is called to review her. She is severely hypoxic and confused and a decision is made to intubate her.

      Which of these drugs is ideal as an induction agent in this patient?

      Your Answer:

      Correct Answer: Ketamine

      Explanation:

      Only about 2% of asthma attacks requires intubation and most severe cases are managed with non-invasive ventilation techniques.

      Though life-saving in the crashing asthmatic, intubation in asthmatic patients is associated with significant morbidity and mortality and is risky. Indications for intubation in asthmatic patients include:
      Severe hypoxia
      Altered mental state
      Respiratory or cardiac arrest
      Failure to respond to medications

      Ketamine (1-2 mg/kg) is the preferred induction agent. It has bronchodilatory properties and does not cause hypotension.

      Propofol poses a risk of hypotension but can also be used.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds

  • Question 27 - Regarding bile acids, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding bile acids, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: The main primary bile acids are deoxycholic acid and lithocholic acid.

      Explanation:

      Bile acids have a hydrophobic and a hydrophilic end and in aqueous solution, bile salts orient themselves around droplets of lipid forming micelles to keep the lipid droplets dispersed. The principal primary bile acids are cholic acid and chenodeoxycholic acid. They are made more soluble by conjugation with taurine or glycine in the liver. 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds

  • Question 28 - What is the approximate lifespan of the mature erythrocyte: ...

    Incorrect

    • What is the approximate lifespan of the mature erythrocyte:

      Your Answer:

      Correct Answer: 120 days

      Explanation:

      Erythrocytes have a normal lifespan of about 120 days. Mature erythrocytes are biconcave discs with no nucleus, ribosomes or mitochondria but with the ability to generate energy as ATP by the anaerobic glycolytic pathway. The red cell membrane consists of a bipolar lipid layer with a membrane skeleton of penetrating and integral proteins anchoring carbohydrate surface antigens. The shape and flexibility of red cells allows them to deform easily and pass through capillaries.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 29 - A 39-year-old guy comes to the emergency room with a persistent nasal bleed....

    Incorrect

    • A 39-year-old guy comes to the emergency room with a persistent nasal bleed. You suspect the bleeding is coming from Little's area based on your examination. Which of the blood vessels listed below is most likely to be involved:

      Your Answer:

      Correct Answer: Sphenopalatine and superior labial arteries

      Explanation:

      The Kiesselbach plexus is a vascular network formed by five arteries that supply oxygenated blood to the nasal septum, which refers to the wall separating the right and left sides of the nose. The five arteries that form the Kiesselbach plexus: the sphenopalatine artery, which branches from the maxillary artery originating behind the jawbone; the anterior ethmoidal artery, which branches from the ophthalmic artery behind the eye; the posterior ethmoidal artery, which also branches from the ophthalmic artery; the septal branch of the superior labial artery, which is a branch of the facial artery supplying blood to all of the superficial features of the face; and finally, the greater palatine artery, which is a terminal branch of the maxillary artery.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
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  • Question 30 - The last two segments of the nephrons are the distal convoluted tubule (DCT)...

    Incorrect

    • The last two segments of the nephrons are the distal convoluted tubule (DCT) and collecting duct (CD).

      Which cell reabsorbs sodium more in the late DCT and CD?

      Your Answer:

      Correct Answer: Principal cells

      Explanation:

      The main Na+ reabsorbing cells in the late distal convoluted tubule and collecting duct are the principal cells. These make up the majority of the tubular cells.

      The exchange is driven by the Na.K.ATPase pumps on the basolateral membrane.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
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