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  • Question 1 - The causative organism for an infection in a patient you are reviewing...

    Correct

    • The causative organism for an infection in a patient you are reviewing is a facultative anaerobe.

      Which of these is a facultative anaerobic organism?

      Your Answer: Staphylococcus aureus

      Explanation:

      Facultative anaerobic bacteria make energy in the form of ATP by aerobic respiration in an oxygen rich environment and can switch to fermentation in an oxygen poor environment.

      Examples of facultative anaerobes are:
      Staphylococcus spp.
      Listeria spp.
      Streptococcus spp.
      Escherichia coli

      Mycobacterium tuberculosis, and Pseudomonas aeruginosa are obligate aerobe. They require oxygen to grow

      Campylobacter jejuni and Clostridium spp are obligate anaerobes.
      They live and grow in the absence of oxygen.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      8.2
      Seconds
  • Question 2 - Which of the following occurs primarily to produce passive expiration: ...

    Incorrect

    • Which of the following occurs primarily to produce passive expiration:

      Your Answer: Contraction of diaphragm and external intercostal muscles

      Correct Answer: Relaxation of diaphragm and external intercostal muscles

      Explanation:

      Passive expiration is produced primarily by relaxation of the inspiratory muscles (diaphragm and external intercostal muscles) and the elastic recoil of the lungs. In expiration, depression of the sternal ends of the ribs (‘pump handle’ movement), depression of the lateral shafts of the ribs (‘bucket handle’ movement) and elevation of the diaphragm result in a reduction of the thorax in an anteroposterior, transverse and vertical direction respectively. This results in a decreased intrathoracic volume and increased intrathoracic pressure and thus air is forced out of the lungs.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      28.1
      Seconds
  • Question 3 - A 20-year-old asthmatic patient's symptoms is deteriorating and patient is moved to the...

    Incorrect

    • A 20-year-old asthmatic patient's symptoms is deteriorating and patient is moved to the resuscitation area of the Emergency Department. A loading dose of IV aminophylline is administered and her symptoms begin to improve. You are asked to check her theophylline levels after an appropriate time period.

      How long should you wait before taking her blood sample be taken?

      Your Answer: 12 hours

      Correct Answer: 4-6 hours

      Explanation:

      Plasma theophylline concentration is usually measured five days after starting oral treatment and three days after each dose adjustment.

      A blood sample to check theophylline concentration should usually be taken after 4-6 hours if an IV dose of aminophylline was given.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      27.2
      Seconds
  • Question 4 - A newborn baby is born by vaginal delivery to a mother who has...

    Correct

    • A newborn baby is born by vaginal delivery to a mother who has a Chlamydia infection and who is started on treatment after the delivery. The neonate subsequently develops an infection also.

      Which one of these is the most common neonatal manifestation of Chlamydia trachomatis infection?

      Your Answer: Conjunctivitis

      Explanation:

      Conjunctivitis is the most common neonatal manifestation of Chlamydia trachomatis infection. The second commonest neonatal manifestation is pneumonia

      Ophthalmia neonatorum refers to any conjunctivitis in the newborn period, irrespective of causative organism. Presently, chlamydia is the single most common cause, accounting for up to 40% of cases. Ophthalmia neonatorum caused by chlamydia typically presents 5 to 14 days after birth with unilateral or bilateral watery discharge that progressively becomes more copious and purulent. There is no associated risk of ulceration and perforation, and the eyes are less inflamed.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      32.1
      Seconds
  • Question 5 - One of these statements about significance tests is true. ...

    Incorrect

    • One of these statements about significance tests is true.

      Your Answer: A type I error occurs when the null hypothesis has been accepted when it is actually false

      Correct Answer: A p value of less than 1 in 20 is considered ‘statistically significant’

      Explanation:

      The p value is statistically significant when it is less than 0.05 (5% or 1 in 20).

      Statistical significance is not the same as clinical significance.

      The null hypothesis states that there is no difference between the groups.

      The power of a study is the probability of correctly rejecting the null hypothesis when it is false.

      A type I error occurs when the null hypothesis has been rejected when it is true. A type II error occurs when the null hypothesis has been accepted when it is actually false.

    • This question is part of the following fields:

      • Evidence Based Medicine
      69.9
      Seconds
  • Question 6 - A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense,...

    Incorrect

    • A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense, vibratory sense, and discriminatory touch. Upon further physical examination, it was observed that her tongue deviates to the left-hand side. An MRI and CT scan was ordered and results showed that he was suffering a left-sided stroke.

      Branches of which of the following arteries are most likely implicated in the case?

      Your Answer: Vertebral artery

      Correct Answer: Anterior spinal artery

      Explanation:

      Medial medullary syndrome is a form of stroke that affects the medial medulla of the brain. It is caused by a lesion in the medial part of the medulla, which is due to an infraction of vertebral arteries and/or paramedian branches of the anterior spinal artery.

      It is characterized by contralateral paralysis of the upper and lower limb of the body, a contralateral decrease in proprioception, vibration, and/or fine touch sensation, paresthesias or less commonly dysesthesias in the contralateral trunk and lower limb, and loss of position and vibration sense with proprioceptive dysfunction. Ipsilateral deviation of the tongue due to ipsilateral hypoglossal nerve damage can also be seen.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      11.9
      Seconds
  • Question 7 - At which vertebral level does the spinal cord normally end in adults? ...

    Incorrect

    • At which vertebral level does the spinal cord normally end in adults?

      Your Answer: L2/L3

      Correct Answer: L1/L2

      Explanation:

      The spinal cord starts at the foramen magnum, where it is continuous with the medulla oblongata, which is the most caudal portion of the brainstem.

      It then extends inferiorly through the vertebral canal. In adults, it usually ends at the level of the first or second lumbar vertebra.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      23.5
      Seconds
  • Question 8 - Gastric emptying is inhibited by all of the following EXCEPT for: ...

    Incorrect

    • Gastric emptying is inhibited by all of the following EXCEPT for:

      Your Answer: Distension of the duodenum

      Correct Answer: Parasympathetic stimulation

      Explanation:

      Gastric emptying is decreased by:
      Enterogastric inhibitory reflexes stimulated by – Distension of the duodenum, The presence of fats in the duodenum (by stimulating release of cholecystokinin), A fall in the pH of chyme in the duodenum, An increase in the osmolality of chyme in the duodenum, Irritation of the mucosal lining of the duodenum, Hormones: Cholecystokinin, Secretin

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      8.4
      Seconds
  • Question 9 - A 60-year-old man comes to your department with complaints of epigastric pain. There...

    Incorrect

    • A 60-year-old man comes to your department with complaints of epigastric pain. There is a history of rheumatoid arthritis and he has been taking ibuprofen 200 mg TDS for the last 2 weeks.

      The following scenarios would prompt you to consider the co-prescription of a PPI for gastroprotection with NSAIDs EXCEPT?

      Your Answer: Co-prescription of fluoxetine

      Correct Answer: Long-term use for chronic back pain in a patient aged 30

      Explanation:

      The current recommendations by NICE suggest that gastro-protection should be considered if patients have ≥1 of the following:

      Aged 65 or older
      – Using maximum recommended dose of an NSAID
      – History of peptic ulcer or GI bleeding
      – Concomitant use of: antidepressants like SSRIs and SNRIs, Corticosteroids, anticoagulants and low dose aspirin
      – Long-term NSAID usage for: long-term back pain if older than 45 and patients with OA or RA at any age

      The maximum recommended dose of ibuprofen is 2.4 g daily and this patient is on 400 mg of ibuprofen TDS.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      87.7
      Seconds
  • Question 10 - Cefotaxime (or ceftriaxone) is used first line for which of the following infections:...

    Incorrect

    • Cefotaxime (or ceftriaxone) is used first line for which of the following infections:

      Your Answer: Blind treatment of native valve endocarditis

      Correct Answer: Blind treatment of suspected bacterial meningitis

      Explanation:

      Cefotaxime (or ceftriaxone) are indicated first line in:
      – Blind treatment of meningitis in patients > 3 months (with amoxicillin if patient > 50 years)
      – Meningitis caused by meningococci
      – Meningitis caused by pneumococci
      – Meningitis caused by H. influenzae
      – Severe or invasive salmonellosis
      – Typhoid fever
      – Gonorrhoea
      – Gonococcal arthritis
      – Haemophilus influenzae epiglottitis

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      28.6
      Seconds
  • Question 11 - You examine a child who has been admitted to the paediatric emergency department...

    Correct

    • You examine a child who has been admitted to the paediatric emergency department with a flu-like illness. His parents tell you that he was born with an inborn defect of steroid metabolism and that he was treated for it with hormone replacement therapy.

      Which of the following is classified as a steroid hormone?

      Your Answer: Aldosterone

      Explanation:

      Hormones can be classified into three categories depending on their chemical composition: amines, peptides (and proteins), and steroids. Amines are made up of single amino acids (for example, tyrosine), peptide hormones are made up of peptides (or proteins), and steroid hormones are made up of cholesterol.
      The table below lists some prominent instances of each of these three hormone classes:

      1. Peptide hormone:
      Adrenocorticotropic hormone (ACTH)
      Prolactin
      Vasopressin
      Oxytocin
      Glucagon
      Insulin
      Somatostatin
      Cholecystokinin

      2. Amine hormone:
      Adrenaline (epinephrine)
      Noradrenaline (norepinephrine)
      Dopamine

      3. Steroid hormone:
      Mineralocorticoids (e.g. aldosterone)
      Glucocorticoids (e.g. cortisol)
      Progestogens
      Androgens
      Oestrogens

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      22.4
      Seconds
  • Question 12 - A patient with history of weight loss and diarrhoea was found out to...

    Incorrect

    • A patient with history of weight loss and diarrhoea was found out to have Giardia lamblia in her stool since returning from a holiday to Nepal.

      Which of the following statements is considered true regarding the life cycle of Giardia lamblia?

      Your Answer: It is mainly transmitted via the aerosol route

      Correct Answer: Trophozoites attach to the intestinal wall via a specialised sucking disc

      Explanation:

      Cysts are resistant forms and are responsible for transmission of giardiasis. Both cysts and trophozoites can be found in the faeces (diagnostic stages). The cysts are hardy and can survive several months in cold water. Infection occurs by the ingestion of cysts in contaminated water, food, or by the faecal-oral route (hands or fomites).
      In the small intestine, excystation releases trophozoites (each cyst produces two trophozoites).
      Trophozoites multiply by longitudinal binary fission, remaining in the lumen of the proximal small bowel where they can be free or attached to the mucosa by a ventral sucking disk.
      Encystation occurs as the parasites transit toward the colon. The cyst is the stage found most commonly in non diarrheal faeces.
      Because the cysts are infectious when passed in the stool or shortly afterward, person-to-person transmission is possible. While animals are infected with Giardia, their importance as a reservoir is unclear.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      76.5
      Seconds
  • Question 13 - Which of the following is NOT a typical complication associated with mumps: ...

    Incorrect

    • Which of the following is NOT a typical complication associated with mumps:

      Your Answer: Meningitis

      Correct Answer: Subacute sclerosing panencephalitis

      Explanation:

      Complications of mumps include meningitis, post meningitis deafness, encephalitis, pancreatitis, orchitis and oophoritis. Subacute sclerosing panencephalitis is a complication typically associated with measles infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      9.3
      Seconds
  • Question 14 - A 6-year-old girl is brought into the paediatric emergency room by her mother...

    Incorrect

    • A 6-year-old girl is brought into the paediatric emergency room by her mother in a state of high-grade fever and extreme irritability. She is also reluctant to urinate as it is associated with lower abdominal pain and stinging. She has no history of any UTIs requiring antibiotics in the past 12 months.

      The urine sensitivity test report is still unavailable. A clean catch urine sample is taken for urine dipstick, which reveals the presence of blood, protein, leukocytes and nitrites. Fresh blood tests were sent, and her estimated GFR is calculated to be 40 ml/minute.

      Out of the following, which antibiotic is most appropriate to be prescribed to this patient?

      Your Answer: Ciprofloxacin

      Correct Answer: Trimethoprim

      Explanation:

      The NICE guidelines for children and young people under 16 years lower UTIs are:
      1. Get a urine sample before antibiotics are taken, and do a dipstick test OR send for culture and susceptibility
      2. Assess and manage children under 5 with lower UTI with fever as recommended in the NICE guideline on fever in under 5s.
      3. Prescribe an immediate antibiotic prescription and take into account the previous urine culture and susceptibility results, previous antibiotic use, which may have led to resistant bacteria
      4. If urine culture and susceptibility report is sent
      – Review the choice of antibiotic when the results are available AND
      – change the antibiotic according to susceptibility results if the bacteria are resistant and symptoms are not improving, using a narrow-spectrum antibiotic wherever possible

      The choice of antibiotics for non-pregnant young people under 16 years with lower UTI is summarised below:
      1. Children under 3 months:
      – Refer to paediatric specialist and treat with intravenous antibiotic in line with NICE guideline on fever in under 5s
      2. Children over 3 months:
      – First-choice
      Nitrofurantoin – if eGFR >45 ml/minute
      Trimethoprim – (if low risk of resistance*)
      – Second-choice (no improvement in lower UTI symptoms on first-choice for at least 48 hours, or when first-choice not suitable)
      Nitrofurantoin – if eGFR >45 ml/minute and not used as first-choice
      Amoxicillin (only if culture results available and susceptible)
      Cefalexin

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      5.2
      Seconds
  • Question 15 - A 30-year-old man presents with diarrhoea, fever, vomiting, and abdominal cramps. A stool...

    Incorrect

    • A 30-year-old man presents with diarrhoea, fever, vomiting, and abdominal cramps. A stool culture was ordered and showed growth of Salmonella spp.

      Among the following serotypes of Salmonella spp., which is considered to be the most common cause of salmonella gastroenteritis?

      Your Answer: Serotype A

      Correct Answer: Serotype D

      Explanation:

      A common cause of gastroenteritis, Salmonella enteritidis, and Salmonella typhi, which causes enteric fever, are both group D. Therefore, serotype D Salmonella species are most commonly associated with gastroenteritis.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      31.8
      Seconds
  • Question 16 - You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble...

    Correct

    • You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble breathing after eating peanuts. Which of the following diagnostic tests will confirm this?

      Your Answer: Mast cell tryptase

      Explanation:

      The concentration of serum tryptase rises in anaphylaxis and anaphylactoid responses.

      Because tryptase is a significant component of mast cell granules, mast cell degranulation causes elevated tryptase levels in the blood.

      Although tryptase levels are not always high during anaphylaxis, it is considered a particular marker.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      44.6
      Seconds
  • Question 17 - You see a 63-year-old man with a history of melaena and epigastric discomfort....

    Correct

    • You see a 63-year-old man with a history of melaena and epigastric discomfort. For a few months, he's been taking aspirin.

      Which of the following statements about aspirin's mechanism of action is correct?

      Your Answer: It inhibits both COX-1 and COX-2 at medium to high doses (500-5000 mg per day)

      Explanation:

      Aspirin inhibits cyclo-oxygenase irreversibly by covalently acetylating the cyclo-oxygenase active site in both COX-1 and COX-2. The production of prostaglandin and thromboxane is reduced as a result. As a result, platelet activation and aggregation are reduced. A single dose of aspirin has a half-life of 7-10 days, which is the time it takes for the bone marrow to produce new platelets.

      Aspirin only inhibits COX-1, the enzyme that produces thromboxane A2, at low doses (75 mg per day), and thus has a primarily anti-thrombotic effect.

      Aspirin inhibits both COX-1 and COX-2 at medium to high doses (500-5000 mg per day). COX-2 is involved in the production of prostaglandins, so it has an anti-inflammatory effect at these concentrations.

      Aspirin, when used as an antipyretic for a viral illness in children, can cause Reye’s syndrome. Reye’s syndrome is a potentially fatal liver disease that causes encephalopathy and liver failure.

      The inability of aspirin to reduce platelet production of thromboxane A2, and thus platelet activation and aggregation, is known as aspirin resistance. Although the exact frequency and mechanism of aspirin resistance are unknown, it is thought to affect about 1% of users. Women are more likely than men to experience this phenomenon.

      According to new research, taking aspirin on a regular basis lowers the risk of colorectal cancer. It may also protect against cancers of the breast, bladder, prostate, and lungs.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      14.1
      Seconds
  • Question 18 - Which of the following side effects has limited the use of etomidate as...

    Correct

    • Which of the following side effects has limited the use of etomidate as an intravenous induction agent:

      Your Answer: Adrenocortical suppression

      Explanation:

      Etomidate causes the least cardiovascular depression of the intravenous induction agents, with only a small reduction in the cardiac output and blood pressure. In the past, etomidate was widely used to induce anaesthesia in the shocked, elderly or cardiovascularly unstable patient. However, more recently it has become less popular as a single induction dose blocks the normal stress-induced increase in adrenal cortisol production for 4 – 8 hours, and up to 24 hours in elderly and debilitated patients. Although no increase in mortality has been identified following a single dose during induction of anaesthesia, the use of etomidate has declined due to a perceived potential morbidity.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      9.8
      Seconds
  • Question 19 - A 25-year-old man suffers from a shoulder injury that damaged the nerve that...

    Incorrect

    • A 25-year-old man suffers from a shoulder injury that damaged the nerve that innervates the infraspinatus muscle.

      Which of the following nerves may most likely be affected?

      Your Answer: The lower subscapular nerve

      Correct Answer: The suprascapular nerve

      Explanation:

      The suprascapular nerve (C5-C6) innervates the infraspinatus. It originates at the superior trunk of the brachial plexus. It runs laterally across the lateral cervical region to supply the infraspinatus and also the supraspinatus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.3
      Seconds
  • Question 20 - Regarding a cohort study, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding a cohort study, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: It is useful for rare diseases.

      Explanation:

      A cohort study is a longitudinal, prospective, observational study that follows a defined group (cohort) matched to unexposed controls for a set period of time and investigates the effect of exposure to a risk factor on a particular future outcome. The usual outcome measure is the relative risk (risk ratio). A large sample size is required for a rare outcome of interest so it is not useful for rare diseases.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      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 - Regarding the lacrimal apparatus, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

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

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 23 - Regarding atracurium, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Effects such as flushing, tachycardia and hypotension can occur due to significant histamine release.

      Explanation:

      Cardiovascular effects such as flushing, tachycardia, hypotension and bronchospasm are associated with significant histamine release; histamine release can be minimised by administering slowly or in divided doses over at least 1 minute. Atracurium undergoes non-enzymatic metabolism which is independent of liver and kidney function, thus allowing its use in patients with hepatic or renal impairment. Atracurium has no sedative or analgesic effects. All non-depolarising drugs should be used with care in patients suspected to be suffering with myasthenia gravis or myasthenic syndrome, as patients with these conditions are extremely sensitive to their effects and may require a reduction in dose.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
      Seconds
  • Question 24 - Which of the following is NOT a typical clinical feature of beta-thalassaemia major:...

    Incorrect

    • Which of the following is NOT a typical clinical feature of beta-thalassaemia major:

      Your Answer:

      Correct Answer: Increased bleeding tendency

      Explanation:

      Features include:
      – severe anaemia (becoming apparent at 3 – 6 months when the switch from gamma-chain to beta-chain production takes place)
      – failure to thrive
      – hepatosplenomegaly (due to excessive red cell destruction, extramedullary haemopoiesis and later due to transfusion related iron overload)
      – expansion of bones (due to marrow hyperplasia, resulting in bossing of the skull and cortical thinning with tendency to fracture)
      – increased susceptibility to infections (due to anaemia, iron overload, transfusion and splenectomy)
      – osteoporosis
      – hyperbilirubinaemia and gallstones
      – hyperuricaemia and gout
      – other features of haemolytic anaemia
      – liver damage and other features of iron overload

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 25 - What is the correct adrenaline dose for a patient with pulseless ventricular tachycardia?...

    Incorrect

    • What is the correct adrenaline dose for a patient with pulseless ventricular tachycardia?

      Your Answer:

      Correct Answer: 10 ml of 1 in 10,000 adrenaline solution

      Explanation:

      Ventricular fibrillation or pulseless ventricular tachycardia (VF/VT) are referred to as shockable rhythm.

      IV adrenaline 1 mg (10 mL of 1:10,000 solution) should be administered after 3 shocks and every 3 – 5 minutes/after alternate shocks thereafter for a shockable rhythm.

      For a non-shockable rhythm, 1 mg IV adrenaline should be administered as soon as IV access is obtained, and then every 3 – 5 minutes/after alternate shocks thereafter.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 26 - You evaluate a 80-year-old man who has a history of persistent heart failure...

    Incorrect

    • You evaluate a 80-year-old man who has a history of persistent heart failure and discover that he has generalised oedema.

      Which of the following claims regarding capillary hydrostatic pressure (P c) is false?

      Your Answer:

      Correct Answer: P c increases along the length of the capillary, from arteriole to venule

      Explanation:

      The capillary hydrostatic pressure (Pc) is normally between 15 and 30 millimetres of mercury. Pc Decreases along the capillary’s length, mirroring the arteriolar and venule pressures proximally and distally.
      Pc is determined by the ratio of arteriolar resistance (RA) to venular resistance (RV).

      When the RA/RV ratio is high, the pressure drop across the capillary is modest, and Pcis is close to venule pressure.

      When the ratio of RA/RV is low, the pressure drop across the capillary is considerable, and Pcis is close to arteriolar pressure.

      Pcis closer to the venule pressure and thus more responsive to changes in venous pressure than arteriolar pressure when RA/RV is high.

      Pcis the major force behind fluid pushing out of the capillary bed and into the interstitium.
      It is also the most variable of the forces affecting fluid transport at the capillary, partly because sympathetic-mediated arteriolar vasoconstriction varies.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      0
      Seconds
  • Question 27 - Which of the following describes the pulse pressure: ...

    Incorrect

    • Which of the following describes the pulse pressure:

      Your Answer:

      Correct Answer: Systolic - diastolic pressure

      Explanation:

      During systole, the pressure in the left ventricle increases and blood is ejected into the aorta. The rise in pressure stretches the elastic walls of the aorta and large arteries and drives blood flow. Systolic pressure is the maximum arterial pressure during systole. During diastole, arterial blood flow is partly maintained by elastic recoil of the walls of large arteries. The minimum pressure reached before the next systole is the diastolic pressure. The difference between the systolic and diastolic pressure is the pulse pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 28 - A 62 year old man has sustained a penetrating injury to the submandibular...

    Incorrect

    • A 62 year old man has sustained a penetrating injury to the submandibular triangle. On examination, his tongue is weak and when protruded deviates to the left. Which of the following nerves has most likely been injured:

      Your Answer:

      Correct Answer: Left hypoglossal nerve

      Explanation:

      Damage to the hypoglossal nerve results in weakness of the tongue, with deviation of the tongue towards the weak side on protrusion.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      0
      Seconds
  • Question 29 - While on morning rounds in the medical ward, the attending physician asks a...

    Incorrect

    • While on morning rounds in the medical ward, the attending physician asks a medical student about the differences between transudates and exudates and their causes. The student explains that a transudate is an excess fluid that leaks out of an intravascular compartment due to an imbalance between oncotic and hydrostatic pressures.

      Which ONE of the following conditions will he mention as the cause of a transudate?

      Your Answer:

      Correct Answer: Meig’s syndrome

      Explanation:

      Transudative effusions are caused due to systemic causes leading to increased hydrostatic pressure or decreased oncotic pressure. These include:
      1) Meig’s Syndrome (Ovarian tumour causing ascites and pleural effusion)
      2) Congestive heart failure
      3) Nephrotic Syndrome
      4) Myxoedema
      5) Cirrhosis
      6) Sarcoidosis

      An exudate is caused by local inflammation and results from increased vascular permeability. Causes include:
      1) Rheumatoid arthritis
      2) Pneumonia leading to empyema
      3) Malignancies
      4) Pericarditis

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 30 - A 65-year-old man presents with a red, hot, swollen great toe. A diagnosis...

    Incorrect

    • A 65-year-old man presents with a red, hot, swollen great toe. A diagnosis of acute gout is made. His past medical history includes heart failure and type 2 diabetes mellitus.
      Which of the following is the most appropriate medication to use in the treatment of his gout? Select ONE answer only.

      Your Answer:

      Correct Answer: Colchicine

      Explanation:

      In the absence of any contra-indications, high-dose NSAIDs are the first-line treatment for acute gout. Naproxen 750 mg as a stat dose followed by 250 mg TDS is a commonly used and effective regime.
      Aspirin should not be used in gout as it reduces the urinary clearance of urate and interferes with the action of uricosuric agents. Naproxen, Diclofenac or Indomethacin are more appropriate choices.
      Allopurinol is used prophylactically, preventing future attacks by reducing serum uric acid levels. It should not be started in the acute phase as it increases the severity and duration of symptoms.
      Colchicine acts on the neutrophils, binding to tubulin to prevent neutrophil migration into the joint. It is as effective as NSAIDs in relieving acute attacks. It also has a role in prophylactic treatment if Allopurinol is not tolerated.
      NSAIDs are contra-indicated in heart failure as they can cause fluid retention and congestive cardiac failure. Colchicine is the preferred treatment in patients with heart failure or those who are intolerant of NSAIDs.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (2/5) 40%
Principles Of Microbiology (1/2) 50%
Anatomy (0/4) 0%
Thorax (0/1) 0%
Pharmacology (3/7) 43%
Respiratory Pharmacology (0/1) 0%
Specific Pathogen Groups (1/2) 50%
Evidence Based Medicine (0/1) 0%
Central Nervous System (0/1) 0%
Head And Neck (0/1) 0%
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Musculoskeletal Pharmacology (0/1) 0%
Infections (0/2) 0%
Endocrine Physiology (1/1) 100%
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Respiratory (1/1) 100%
CNS Pharmacology (1/1) 100%
Anaesthesia (1/1) 100%
Upper Limb (0/1) 0%
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