00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Mins)
Retry this test Dashboard

  • Question 1 - A 68-year-old man with BPH presents to the emergency department in significant pain...

    Incorrect

    • A 68-year-old man with BPH presents to the emergency department in significant pain secondary to urinary retention. What is the location of the neuronal cell bodies that are responsible for urinary bladder discomfort sensation?

      Your Answer: Dorsal root ganglia of spinal cord levels L1 - L4

      Correct Answer: Dorsal root ganglia of spinal cord levels S2, S3 and S4

      Explanation:

      The activation of stretch receptors with visceral afferents relayed through the pelvic nerve plexus and into the pelvic splanchnic nerves causes bladder pain. The sensory fibres of spinal nerves S2 – S4 enter the dorsal root ganglia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      77
      Seconds

  • Question 2 - Regarding hepatitis C, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding hepatitis C, which of the following statements is INCORRECT:

      Your Answer: Primary infection is often asymptomatic.

      Correct Answer: Anti-HCV IgG antibodies are diagnostic of acute infection.

      Explanation:

      Anti-HCV IgG antibodies indicate exposure to hepatitis C but this could be acute, chronic or resolved infection. If the antibody test is positive, HCV RNA should be tested for, which if positive indicates that a person has current infection with active hepatitis C.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      113.1
      Seconds

  • Question 3 - Which of the following ions normally has the highest concentration in intracellular fluid: ...

    Correct

    • Which of the following ions normally has the highest concentration in intracellular fluid:

      Your Answer: K +

      Explanation:

      Potassium (K+) is the principal intracellular ion; approximately 4 mmol/L is extracellular (3%) and 140 mmol/L intracellular (97%).

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      16.1
      Seconds

  • Question 4 - A 68-year-old female has presented to the Emergency Department with chest pain, palpitations,...

    Correct

    • A 68-year-old female has presented to the Emergency Department with chest pain, palpitations, and breathlessness complaints. On ECG, she is diagnosed with ventricular arrhythmia and is administered lidocaine.

      Which of the following is the correct mechanism of action of lidocaine?

      Your Answer: Blocks Na+ channels in the heart

      Explanation:

      Lidocaine is a tertiary amide local anaesthetic and also a class IV antiarrhythmic.

      Like other local anaesthetics, lidocaine works on the voltage-gated sodium ion channel on the nerve cell membranes. It works in the following steps:
      1. diffuses through neural sheaths and the axonal membrane into the axoplasm
      2. binds fast voltage-gated Na+ channels in the neuronal cell membrane and inactivates them
      3. With sufficient blockage, the membrane of the postsynaptic neuron will not depolarise and will be unable to transmit an action potential, thereby preventing the transmission of pain signals

      The same principle applies to Lidocaine’s actions in the heart as it blocks the sodium channels in the conduction system and the myocardium. This raises the threshold for depolarizing, making it less likely for the heart to initiate or conduct any action potential that can cause arrhythmia.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      40.3
      Seconds

  • Question 5 - A patient presents with a laceration on his hand and wrist that has...

    Correct

    • A patient presents with a laceration on his hand and wrist that has cut the nerve that innervates opponens pollicis.
      The opponens pollicis muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: The recurrent branch of the median nerve

      Explanation:

      Opponens pollicis is a small, triangular muscle that forms part of the thenar eminence. It originates from the flexor retinaculum and the tubercle of trapezium bone and inserts into the whole length of the first metacarpal bone on its radial side.
      Opponens pollicis is innervated by the recurrent branch of the median nerve and receives its blood supply from the superficial palmar arch.
      The main action of opponens pollicis is to flex the first metacarpal bone at the carpometacarpal joint, which opposes the thumb towards the centre of the palm. It also medially rotates the first metacarpal bone at the carpometacarpal joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      70.1
      Seconds

  • Question 6 - An ambulance transports a 72-year-old woman to the Emergency Department. She is confused,...

    Incorrect

    • An ambulance transports a 72-year-old woman to the Emergency Department. She is confused, has been vomiting and having stomach pains. Digoxin is one of her medications.

      Which of the following claims about digoxin is correct?

      Your Answer: Hyperkalaemia can predispose to digoxin toxicity

      Correct Answer: Therapeutic plasma levels are between 1.0-1.5 nmol/l

      Explanation:

      Digoxin is a cardiac glycoside that is used to treat atrial fibrillation and flutter, as well as congestive heart failure. In cardiac myocytes, it works by inhibiting the membrane Na/K ATPase. Through Na/Ca exchange, this raises intracellular sodium concentration and indirectly increases intracellular calcium availability. Increased intracellular calcium levels have both a positive inotropic and negative chronotropic effect.

      Digoxin therapeutic plasma levels are typically between 1.0 and 1.5 nmol/l, though higher concentrations may be required, and the value varies between laboratories. At concentrations greater than 2 nmol/l, the risk of toxicity increases dramatically.

      In patients with normal renal function, digoxin has a long plasma half-life of 36 to 48 hours. This can take up to 5 days in patients with impaired renal function.

      Hypokalaemia, rather than hyperkalaemia, has been shown to increase the risk of digoxin toxicity.

      In the treatment of persistent and permanent atrial fibrillation, digoxin is no longer widely used. Beta-blockers, also known as rate-limiting calcium channel blockers, are now the first-line treatment for this condition.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      32
      Seconds

  • Question 7 - In all of the following conditions, lymphocytosis typically occurs except for: ...

    Incorrect

    • In all of the following conditions, lymphocytosis typically occurs except for:

      Your Answer: Chronic lymphocytic leukaemia

      Correct Answer: Corticosteroid therapy

      Explanation:

      In infants and young children, lymphocytosis often occurs in response to infections that would normally produce a neutrophil reaction in adults.
      Lymphocytosis occurs in:
      1. Viral infections (e.g. infectious mononucleosis, HIV, rubella, mumps, viral hepatitis, cytomegalovirus, herpes simplex or zoster)
      2. Bacterial infections (e.g. pertussis, tuberculosis, toxoplasmosis, syphilis)
      3. Chronic lymphoid leukaemias
      4. Acute lymphoblastic leukaemias
      5. Non-Hodgkin lymphoma
      6. Thyrotoxicosis

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      124.4
      Seconds

  • Question 8 - A 24-year-old waiter cuts his hand on a dropped plate that smashed and...

    Correct

    • A 24-year-old waiter cuts his hand on a dropped plate that smashed and damages the nerve that innervates opponens digiti minimi.
      The opponens digiti minimi muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: The deep branch of the ulnar nerve

      Explanation:

      Opponens digiti minimi is a triangular-shaped muscle in the hand that forms part of the hypothenar eminence. It originates from the hook of the hamate bone and the flexor retinaculum and inserts into the medial border of the 5thmetacarpal.
      Opponens digiti minimi is innervated by the deep branch of the ulnar nerve and receives its blood supply from the ulnar artery.
      Opponens digiti minimi draws the fifth metacarpal bone anteriorly and rotates it, bringing the fifth digiti into opposition with the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      44.9
      Seconds

  • Question 9 - A 49-year-old man known sickle cell disease patient received a blood transfusion and...

    Incorrect

    • A 49-year-old man known sickle cell disease patient received a blood transfusion and developed a mild fever and dark urine 6 days after transfusion. His investigations show raised bilirubin, raised LDH, and a positive Direct Antiglobulin Test (DAT).

      Which transfusion reaction is most likely occurred?

      Your Answer: Acute haemolytic reaction

      Correct Answer: Delayed haemolytic reaction

      Explanation:

      Delayed haemolytic transfusion reactions (DHTRs) commonly occurs 4-8 days after blood transfusion, but can occur up to a month after. Signs and symptoms include jaundice, fever, an inadequate rise in PCV, reticulocytosis, a positive antibody screen and a positive Direct Antiglobulin Test (Coombs test). DHTRs usually have a benign course and require no treatment but sometimes, life-threatening haemolysis with severe anaemia and renal failure can occur so haemoglobin levels and renal function should be monitored.

      Acute haemolytic reaction aka immediate haemolytic transfusion reaction presents with fever, chills, pain at transfusion site, nausea, vomiting, dark urine and feeling of ‘impending doom’. Often, it occurs due to ABO incompatibility.

      Febrile transfusion reaction presents with a 1 degree rise in temperature from baseline during transfusion. Patient may have chills and malaise. It is the most common transfusion reaction (1 in 8 transfusions) and is usually caused by cytokines released from leukocytes in transfused red cell or platelet components.

      Transfusion-associated circulatory overload (TACO) presents as acute or worsening respiratory distress within 6 hours of transfusion of a large volume of blood. It is common in patients with diminished cardiac reserve or chronic anaemia. Elderly patients, infants and severely anaemic patients are particularly susceptible. Clinical features of TACO include: Acute respiratory distress, Tachycardia, Hypertension, Acute/worsening pulmonary oedema on chest X-ray. The BNP is usually raised to at least 1.5 times the pre-transfusion baseline.

      Graft versus host disease(GVHD) is an immune mediated condition that arises from a complex interaction between donor and recipients adaptive immunity. It presents as dermatitis, hepatitis and enteritis developing within 100 days after stem cell or bone marrow transplant.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      82.6
      Seconds

  • Question 10 - A 33-year-old woman who is investigated for recurrent renal stones is discovered to...

    Correct

    • A 33-year-old woman who is investigated for recurrent renal stones is discovered to have a markedly elevated parathyroid hormone (PTH) level.
      Which of the following would stimulate PTH release under normal circumstances? Select ONE answer only.

      Your Answer: Decreased plasma calcium concentration

      Explanation:

      Parathyroid hormone (PTH) is a polypeptide containing 84 amino acids. It is the principal controller of free calcium in the body.
      PTH is synthesised by and released from the chief cells of the four parathyroid glands that are located immediately behind the thyroid gland.
      PTH is released in response to the following stimuli:
      Decreased plasma calcium concentration
      Increased plasma phosphate concentration (indirectly by binding to plasma calcium and reducing the calcium concentration)
      PTH release is inhibited by the following factors:
      Normal/increased plasma calcium concentration
      Hypomagnesaemia
      The main actions of PTH are:
      Increases plasma calcium concentration
      Decreases plasma phosphate concentration
      Increases osteoclastic activity (increasing calcium and phosphate resorption from bone)
      Increases renal tubular reabsorption of calcium
      Decreases renal phosphate reabsorption
      Increases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol (via stimulation of 1-alpha hydroxylase)
      Increases calcium and phosphate absorption in the small intestine (indirectly via increased 1,25-dihydroxycholecalciferol)

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      29.3
      Seconds

  • Question 11 - In adults, there are normally how many teeth: ...

    Incorrect

    • In adults, there are normally how many teeth:

      Your Answer: 30

      Correct Answer: 32

      Explanation:

      In adults, there are 32 teeth, 16 in the upper jaw and 16 in the lower jaw. On each side in both upper and lower arches, there are two incisors, one canine, two premolars and three molar teeth.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      110.1
      Seconds

  • Question 12 - Regarding a case-control study, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding a case-control study, which of the following statements is INCORRECT:

      Your Answer: It is observational.

      Correct Answer: The usual outcome measure is the relative risk.

      Explanation:

      A case-control study is a longitudinal, retrospective, observational study which investigates the relationship between a risk factor and one or more outcomes. This is done by selecting patients who already have a specific disease (cases), matching them to patients who do not (controls) and then collecting data from the patients to compare past exposure to a possible risk factor. The usual outcome measure is the odds ratio.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      24.5
      Seconds

  • Question 13 - A 29-year-old man is diagnosed with a severe case of asthma.

    In the treatment...

    Incorrect

    • A 29-year-old man is diagnosed with a severe case of asthma.

      In the treatment of acute asthma in adults, which of the following is NOT recommended?

      Your Answer: IV salbutamol

      Correct Answer: Nebulised magnesium

      Explanation:

      There is no evidence to support the use of nebulized magnesium sulphate in the treatment of adults at this time.

      In adults with acute asthma, the following medication dosages are recommended:
      By using an oxygen-driven nebuliser, you can get 5 milligrams of salbutamol.
      500 mcg ipratropium bromide in an oxygen-driven nebuliser
      Oral prednisolone 40-50 mg
      100 mg hydrocortisone intravenous
      1.2-2 g magnesium sulphate IV over 20 minutes
      When inhaled treatment is ineffective, intravenous salbutamol (250 mcg IV slowly) may be explored (e.g. a patient receiving bag-mask ventilation).

      Following senior counsel, current ALS recommendations propose that IV aminophylline be explored in severe or life-threatening asthma. If utilized, a loading dose of 5 mg/kg should be administered over 20 minutes, then a 500-700 mcg/kg/hour infusion should be given. To avoid toxicity, serum theophylline levels should be kept below 20 mcg/ml.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      6
      Seconds

  • Question 14 - Which lobe of the prostate gland is most commonly affected in benign prostatic...

    Incorrect

    • Which lobe of the prostate gland is most commonly affected in benign prostatic hypertrophy?

      Your Answer: Left lateral

      Correct Answer: Median

      Explanation:

      Benign enlargement of the prostate is common in men older than 50 years. The cause is possibly an imbalance in the hormonal control of the gland. The median lobe of the gland enlarges upward and encroaches within the sphincter vesicae, located at the neck of the bladder. The leakage of urine into the prostatic urethra causes an intense reflex desire to micturate. The enlargement of the median and lateral lobes of the gland produces elongation and lateral compression and distortion of the urethra so that the patient experiences difficulty in passing urine and the stream is weak. Back-pressure effects on the ureters and both kidneys are a common complication. The enlargement of the uvula vesicae (owing to the enlarged median lobe) results in the formation of a pouch of stagnant urine behind the urethral orifice within the bladder. The stagnant urine frequently becomes infected, and the inflamed bladder (cystitis) adds to the patient’s symptoms.

      In all operations on the prostate, the surgeon regards the prostatic venous plexus with respect. The veins have thin walls, are valveless, and are drained by several large trunks directly into the internal iliac veins. Damage to these veins can result in a severe haemorrhage.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      42.3
      Seconds

  • Question 15 - A 1-year-old male is brought to the paediatrician by his mother due to...

    Incorrect

    • A 1-year-old male is brought to the paediatrician by his mother due to swelling of the right knee after a minor fall. On examination, the right knee is swollen, fluctuant and tender. Ultrasound-guided aspiration reveals a massive hemarthrosis. Family history shows that his older brother also has a bleeding disorder.

      Which one of the following conditions does the patient most likely have?

      Your Answer: Von Willebrand disease

      Correct Answer: Haemophilia A

      Explanation:

      A diagnosis of Haemophilia is supported in this patient by the family history and the presence of hemarthrosis-both characteristics of Haemophilia. Haemophilia A is caused by Factor VIII deficiency, leading to impaired coagulation. This disease typically presents after six months when the child starts crawling.

      Von Willebrand disease presents with nosebleeds and hematomas. Idiopathic thrombocytopenic purpura presents with bruises that resemble a rash.

      Glucose-6-phosphate dehydrogenase (G6PD) deficiency presents with haemolytic anaemia induced by specific drugs or foods.

      Factor V Leiden mutation causes blood clotting rather than bleeding.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      44.6
      Seconds

  • Question 16 - All of the following statements are incorrect about insulin except: ...

    Correct

    • All of the following statements are incorrect about insulin except:

      Your Answer: Proinsulin is cleaved into insulin and C peptide.

      Explanation:

      Proinsulin is synthesised as a single-chain peptide. A connecting peptide (C peptide) within storage granules is removed by proteases to yield insulin.

      Insulin:
      1. is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds.
      2. is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas.
      3. release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin. However, most output is driven by the rise in plasma glucose concentration that occurs after a meal.
      4. effects are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      247.8
      Seconds

  • Question 17 - A man suffered from a back injury due to a fall from a...

    Incorrect

    • A man suffered from a back injury due to a fall from a ladder. Significant bruising was found to be overlying his latissimus dorsi muscle.

      Which of the following statements regarding the latissimus dorsi muscle is considered correct?

      Your Answer: It originates from the upper part of the back

      Correct Answer: It raises the body towards the arm during climbing

      Explanation:

      The latissimus dorsi muscle is a broad, flat muscle that occupies the majority of the lower posterior thorax. The muscle’s primary function is of the upper extremity but is also considered to be a respiratory accessory muscle.

      Latissimus dorsi is a climbing muscle. With the arms fixed above the head, it can raise the trunk upwards, together with the help of pectoralis major.

      Functionally, the latissimus dorsi muscle belongs to the muscles of the scapular motion. This muscle is able to pull the inferior angle of the scapula in various directions, producing movements on the shoulder joint (internal rotation, adduction and extension of the arm). It is innervated by the thoracodorsal nerve (C6 – C8) from the posterior cord of the brachial plexus, which enters the muscle on its deep surface.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      30.1
      Seconds

  • Question 18 - Severe vomiting and diarrhoea were reported by a 25-year-old man. He's dehydrated and...

    Incorrect

    • Severe vomiting and diarrhoea were reported by a 25-year-old man. He's dehydrated and needs intravenous fluids to rehydrate. You give him cyclizine as part of his treatment.

      What is cyclizine's main mechanism of action?

      Your Answer: Dopamine receptor antagonism

      Correct Answer: Antihistamine action

      Explanation:

      Cyclizine is a piperazine derivative that functions as an antihistamine (H1-receptor antagonist). To prevent nausea and vomiting, it is thought to act on the chemoreceptor trigger zone (CTZ) and the labyrinthine apparatus. It has a lower antimuscarinic effect as well.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      34.7
      Seconds

  • Question 19 - Which of the following is an example of continuous data: ...

    Incorrect

    • Which of the following is an example of continuous data:

      Your Answer: Gender

      Correct Answer: Height

      Explanation:

      Continuous data is data where there is no limitation on the numerical value that the variable can take e.g. weight, height.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      46.3
      Seconds

  • Question 20 - A 52-year-old patient requires procedural sedation for DC cardioversion of atrial fibrillation. You...

    Incorrect

    • A 52-year-old patient requires procedural sedation for DC cardioversion of atrial fibrillation. You plan on using propofol as the sedative agent.
      Propofol works as a result of action on what type of receptor? Select ONE answer only.

      Your Answer: Serotonin

      Correct Answer: Gamma-aminobutyric acid (GABA)

      Explanation:

      Propofol (2,6-diisopropylphenol) is a short-acting phenol derivative that is primarily used for the induction of anaesthesia.
      Its mechanism of action is unclear but is thought to act by potentiating the inhibitory neurotransmitters GABA and glycine, which enhances spinal inhibition during anaesthesia.
      The dose for induction of anaesthesia is 1.5-2.5mg/kg. The dose for maintenance of anaesthesia is 4-12 mg/kg/hour. Following intravenous injection, propofol acts within 30 seconds and its duration of action is 5-10 minutes.
      Propofol produces a 15-25% decrease in blood pressure and systemic vascular resistance without a compensatory increase in heart rate. It is negatively inotropic and decreases cardiac output by approximately 20%.
      The main side effects of propofol are:
      Pain on injection (in up to 30%)
      Hypotension
      Transient apnoea
      Hyperventilation
      Coughing and hiccough
      Headache
      Thrombosis and phlebitis

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      65.9
      Seconds

  • Question 21 - An 80-year-old female complains of chest pain characteristic of angina. A dose of...

    Incorrect

    • An 80-year-old female complains of chest pain characteristic of angina. A dose of glyceryl trinitrate (GTN) is administered that resolves the chest pain rapidly.

      Which ONE of the following is released on the initial metabolism of GTN?

      Your Answer: Nitrate ions

      Correct Answer: Nitrite ions

      Explanation:

      Angina pectoris is the most common symptom of ischemic heart disease and presents with chest pain relieved by rest and nitro-glycerine.

      Nitrates are the first-line treatment to relieve chest pain caused by angina. The commonly used nitrates are:
      1. Glyceryl trinitrate
      2. Isosorbide dinitrate

      The nitrate drugs are metabolized in the following steps:
      1. Release Nitrite ions (NO2-), which are then converted to nitric oxide (NO) within cells.
      2. NO activates guanylyl cyclase, which causes an increase in the intracellular concentration of cyclic guanosine-monophosphate (cGMP) in vascular smooth muscle cells.
      3. Relaxation of vascular smooth muscle.

      Although nitrates are potent coronary vasodilators, their principal benefit in the management of angina results from a predominant mechanism of venous dilation:
      – Bigger veins hold more blood
      – Takes blood away from the left ventricle
      – Lowers LVEDV (preload), LA pressure
      – Less pulmonary oedema → improved dyspnoea

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      37.7
      Seconds

  • Question 22 - A range of one standard deviation above and below the mean includes what...

    Incorrect

    • A range of one standard deviation above and below the mean includes what approximate percentage of the sample values:

      Your Answer: 0.56

      Correct Answer: 0.68

      Explanation:

      A range of one SD above and below the mean (+/- 1 SD) includes 68.2% of the sample values.
      A range of two SD above and below the mean (+/- 2 SD) includes 95.4% of the sample values.
      A range of three SD above and below the mean (+/- 3 SD) includes 99.7% of the sample values.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      39.7
      Seconds

  • Question 23 - A 24-year-old patient is suspected to have a possible acute hepatitis B infection...

    Incorrect

    • A 24-year-old patient is suspected to have a possible acute hepatitis B infection and is currently under investigation.

      Which of the following markers is considered the earliest indicator of acute infection in acute Hepatitis B?

      Your Answer: Total hepatitis B core antibody

      Correct Answer: Hepatitis B surface Ag

      Explanation:

      HBsAg is the serological hallmark of HBV infection. After an acute exposure to HBV, HBsAg appears in serum within 1 to 10 weeks. Persistence of this marker for more than 6 months implies chronic HBV infection.

      Anti-HBs is known as a neutralizing antibody, and confers long-term immunity. In patients with acquired immunity through vaccination, anti-HBs is the only serological marker detected in serum.

      HBcAg is an intracellular presence in infected hepatocyte, thus it is not identified in the serum. During acute infection, anti-HBc IgM and IgG emerges 1–2 weeks after the presence of HBsAg along with raised serum aminotransferase and symptoms. After 6 months of acute infection, anti-HBc IgM wears off. Anti-HBc IgG continues to detect in both patients with resolved HBV infection and chronic hepatitis B.

      Hepatitis D virus, also known as the delta hepatitis virus, is a defective ssRNA virus that requires HBV for replication. The infection can occur in one of two clinical forms, co-infection or superinfection. In a co-infection, the patient is simultaneously infected with HBV and HDV. In a superinfection, an HDV infection develops in a patient with a chronic HBV infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      158.7
      Seconds

  • Question 24 - Which of the following is NOT one of the cardinal features of acute...

    Incorrect

    • Which of the following is NOT one of the cardinal features of acute inflammation:

      Your Answer: Loss of function

      Correct Answer: Discharge

      Explanation:

      Classic signs:
      Rubor (redness)
      Calor (heat)
      Dolour (pain)
      Tumour (swelling)
      Functio laesa (loss of function)
      These classic signs are produced by a rapid vascular response and cellular events. The main function of these events is to bring elements of the immune system to the site of injury and prevent further tissue damage.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      73.3
      Seconds

  • Question 25 - A 22 year old male has been stabbed and is brought to the...

    Incorrect

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

      Your Answer: Ulnar nerve at wrist

      Correct Answer: Ulnar nerve at elbow

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      403
      Seconds

  • Question 26 - Which of the following statements is correct regarding flow through the cardiovascular system?...

    Incorrect

    • Which of the following statements is correct regarding flow through the cardiovascular system?

      Your Answer: In laminar blood flow, blood flows fastest at the peripheries of the blood vessel.

      Correct Answer: Turbulent blood flow may be caused by increased cardiac output.

      Explanation:

      Frictional forces at the sides of a vessel cause a drag force on the fluid touching them in laminar blood flow, which creates a velocity gradient where the flow is greatest at the centre. Laminar blood flow may become disrupted and flow may become turbulent at high velocities, especially in large arteries or where the velocity increases sharply at points of sudden narrowing in the vessels, or across valves. There is increased tendency for thrombi formation when there is turbulent blood flow. Clinically, turbulence may be heard as a murmur or a bruit. As a result of elevated cardiac output, there may be turbulent blood flow, even when the cardiac valves are anatomically normal, and as a result, a physiological murmur can be heard. One such example is pregnancy.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      147.7
      Seconds

  • Question 27 - Capillaries are designed with a small diffusion distance for nutrition and gaseous exchange...

    Incorrect

    • Capillaries are designed with a small diffusion distance for nutrition and gaseous exchange with the tissues they serve. Capillaries come in a variety of shapes and sizes, each with its own function in transcapillary exchange.

      Which of the following types of capillaries is the least permeable in the human body?

      Your Answer: Incomplete capillaries

      Correct Answer: Continuous capillaries

      Explanation:

      Capillaries are designed with a small diffusion distance for nutrition and gaseous exchange with the tissues they serve. Because oxygen and carbon dioxide are both highly soluble in lipids (lipophilic), they can easily diffuse along a concentration gradient across the endothelial lipid bilayer membrane. In contrast, glucose, electrolytes, and other polar, charged molecules are lipid-insoluble (hydrophilic). These chemicals are unable to pass through the lipid bilayer membrane directly and must instead travel through gaps between endothelial cells.
      Capillaries are divided into three types: continuous, fenestrated, and sinusoidal. Each of these capillary types contains different sized gaps between the endothelial cells that operate as a filter, limiting which molecules and structures can pass through.

      The permeability of capillaries is affected by the wall continuity, which varies depending on the capillary type.
      Skeletal muscle, myocardium, skin, lungs, and connective tissue all have continuous capillaries. These capillaries are the least permeable. They have a basement membrane and a continuous layer of endothelium. The presence of intercellular spaces allows water and hydrophilic molecules to pass across. Tight connections between the cells and the glycocalyx inhibit passage via these gaps, making diffusion 1000-10,000 times slower than for lipophilic compounds. The diffusion of molecules larger than 10,000 Da, such as plasma proteins, is likewise prevented by this narrow pore system. These big substances can pass through the capillary wall, but only very slowly, because endothelial cells have enormous holes.

      The kidneys, gut, and exocrine and endocrine glands all have fenestrated capillaries. These are specialized capillaries that allow fluid to be filtered quickly. Water, nutrients, and hormones can pass via windows or fenestrae in their endothelium, which are connected by a thin porous membrane. They are ten times more permeable than continuous capillaries due to the presence of these fenestrae. Fenestrated capillaries have a healthy basement membrane.
      The spleen, liver, and bone marrow all have sinusoidal capillaries, also known as discontinuous capillaries. Their endothelium has huge gaps of >100 nm, and their basement membrane is inadequate. They are highly permeable as a result, allowing red blood cells to travel freely.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      24.5
      Seconds

  • Question 28 - An 85-year-old woman is brought in from her nursing home. She arrives in...

    Incorrect

    • An 85-year-old woman is brought in from her nursing home. She arrives in the Emergency Department and appears confused. The staff member from the nursing home accompanying her informs you that she takes a water tablet.

      From her past medical history and records, you deduce that the water tablet is a loop diuretic.

      Which of the following parts of a nephron does a loop diuretic act on?

      Your Answer: Distal convoluted tubule

      Correct Answer: Ascending loop of Henlé

      Explanation:

      Loop diuretics are drugs used to manage and treat fluid overload associated with CHF, liver cirrhosis, and renal disease. The drugs commonly used are:
      Furosemide
      Bumetanide
      Torsemide
      Ethacrynic Acid

      Loop diuretics act on the apical membrane of the thick ascending loop of Henle and inhibit the Na-K-Cl cotransporter. This blocks the reabsorption of sodium and chloride and results in salt-water excretion. This relieves congestion and reduces oedema.

      Other diuretics act on the following part of the nephron:
      1. Thiazide diuretics – Na/Cl co-transporter in the distal convoluted tubule
      2. Osmotic diuretics – PCT and the loop of Henle
      3. Aldosterone antagonists – distal convoluted tubule
      4. Carbonic anhydrase inhibitors – inhibit the carbonic anhydrase and act on proximal tubular cells

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      39.8
      Seconds

  • Question 29 - Which JVP waveform correlates to atrial systole? ...

    Incorrect

    • Which JVP waveform correlates to atrial systole?

      Your Answer:

      Correct Answer: The a wave

      Explanation:

      JVP Waveform in Cardiac Cycle Physiology: a wave Right atrial contraction causes atrial systole (end diastole). the c wave During right isovolumetric ventricular contraction, the tricuspid valve bulges into the right atrium, resulting in isovolumetric contraction (early systole). descent by x Rapid ventricular ejection (mid systole) is caused by a combination of right atrial relaxation, tricuspid valve downward movement during right ventricular contraction, and blood ejection from both ventricles. the v-wave Ventricular ejection and isovolumetric relaxation (late systole) occur as a result of venous return filling the right atrium. y lineage Ventricular filling occurs when the tricuspid valve opens, allowing blood to flow rapidly from the right atrium to the right ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 30 - 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 31 - Following a bee sting, a 8-year old boy was transported to resus with...

    Incorrect

    • Following a bee sting, a 8-year old boy was transported to resus with symptoms and signs of an anaphylactic reaction. You decide to administer adrenaline IM stat. What is the recommended dose of intramuscular adrenaline?

      Your Answer:

      Correct Answer: 0.3 mL of 1:1000

      Explanation:

      Anaphylaxis is a type I hypersensitivity reaction that is severe and life-threatening. It is marked by the fast onset of life-threatening airway and/or circulatory issues, which are generally accompanied by skin and mucosal abnormalities. When an antigen attaches to specific IgE immunoglobulins on mast cells, degranulation and the release of inflammatory mediators takes place (e.g. histamine, prostaglandins, and leukotrienes).

      The most important medicine for treating anaphylactic responses is adrenaline. It decreases oedema and reverses peripheral vasodilation as an alpha-adrenergic receptor agonist. Its beta-adrenergic effects widen the bronchial airways, enhance the force of cardiac contraction, and inhibit the release of histamine and leukotriene. The first medicine to be given is adrenaline, and the IM route is optimal for most people.

      In anaphylaxis, age-related dosages of IM adrenaline are:
      150 mcg (0.15 mL of 1:1000) for a child under 6 years
      300 mcg (0.3 mL of 1:1000) for a child aged 6 to 12 years
      500 mcg (0.5 mL of 1:1000) for children aged 12 and above
      500 mcg for adults (0.5 mL of 1:1000)

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds

  • Question 32 - You examine an elderly man who is experiencing chest pain. He doesn't recall...

    Incorrect

    • You examine an elderly man who is experiencing chest pain. He doesn't recall all of his medications, but he does know that he takes a diuretic.

      The enzyme carbonic anhydrase is inhibited by which of the following diuretics?

      Your Answer:

      Correct Answer: Acetazolamide

      Explanation:

      Acetazolamide is a non-competitive, reversible inhibitor of carbonic anhydrase found in the cytosol of cells and on the brush border of the proximal convoluted tubule. Bicarbonate and hydrogen ions are converted to carbonic acid by carbonic anhydrase, which then converts carbonic acid to carbon dioxide and water. As a result, acetazolamide reduces the availability of hydrogen ions, causing sodium and bicarbonate ions to accumulate in the renal tubule, resulting in diuresis.
      The mechanism of action of the various types of diuretics is summarised below:

      1) Loop diuretics, e.g. furosemide, bumetanide
      Act on the Na.K.2Cl co-transporters in the ascending loop of Henlé to inhibit sodium, chloride and potassium reabsorption.

      2) Thiazide diuretics, e.g. Bendroflumethiazide, hydrochlorothiazide
      Act on the Na.Cl co-transporter in the distal convoluted tubule to inhibit sodium and chloride reabsorption.

      3) Osmotic diuretics, e.g. mannitol
      Increases the osmolality of the glomerular filtrate and tubular fluid, increasing urinary volume by an osmotic effect.

      4) Aldosterone antagonists, e.g. spironolactone
      Acts in the distal convoluted tubule as a competitive aldosterone antagonist resulting in inhibition of sodium reabsorption and increasing potassium reabsorption.

      5) Carbonic anhydrase inhibitors, e.g. acetazolamide
      Inhibit the enzyme carbonic anhydrase preventing the conversion of bicarbonate and hydrogen ions into carbonic acid.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 33 - The common bile duct drains into the duodenum in which of the following...

    Incorrect

    • The common bile duct drains into the duodenum in which of the following regions:

      Your Answer:

      Correct Answer: Second part of the duodenum

      Explanation:

      As the common bile duct descends, it passes posterior to the first part of the duodenum before joining with the pancreatic duct from the pancreas, forming the hepatopancreatic ampulla (ampulla of Vater) at the major duodenal papilla, located in the second part of the duodenum. Surrounding the ampulla is the sphincter of Oddi, a collection of smooth muscle which can open to allow bile and pancreatic fluid to empty into the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 34 - Despite taking the oral contraceptive pill, a 29-year-old woman becomes pregnant. During a...

    Incorrect

    • Despite taking the oral contraceptive pill, a 29-year-old woman becomes pregnant. During a medication review, you discover that she is epileptic and that her antiepileptic therapy has recently been changed.

      Which of the following antiepileptics is most likely to impair the oral contraceptive pill's effectiveness?

      Your Answer:

      Correct Answer: Carbamazepine

      Explanation:

      The metabolism of ethinyl oestradiol and progestogens has been shown to be increased by enzyme-inducing antiepileptics. The oral contraceptive pill (OCP) is less effective in preventing pregnancy as a result of this increased breakdown.

      Antiepileptic drugs that induce enzymes include:
      Carbamazepine
      Phenytoin
      Phenobarbital
      Topiramate

      Antiepileptics that do not induce enzymes are unlikely to affect contraception. Non-enzyme-inducing anticonvulsants include the following:
      Clonazepam
      Gabapentin
      Levetiracetam
      Piracetam
      Sodium valproate is a type of valproate that is used to

      Lamotrigine is an antiepileptic drug that does not cause the production of enzymes. It does, however, require special consideration, unlike other non-enzyme-inducing antiepileptics. The OCP does not appear to affect epilepsy directly, but it does appear to lower lamotrigine levels in the blood. This could result in a loss of seizure control and the occurrence of seizures.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 35 - A man presents to the emergency department with an injury that has damaged...

    Incorrect

    • A man presents to the emergency department with an injury that has damaged the opponens pollicis muscle.

      Which of the following statements regarding the opponens pollicis muscle is considered correct?

      Your Answer:

      Correct Answer: It flexes the first metacarpal bone at the carpometacarpal joint

      Explanation:

      Opponens pollicis is a muscle of thenar eminence, it is triangular in shape and lies deep to flexor pollicis brevis and abductor pollicis brevis. It originates from the flexor retinaculum, tubercles of scaphoid and trapezium, abductor pollicis longus tendon.

      Its insertion is in the radial side of the base of proximal phalanx of thumb. It is supplied by the median nerve (C8, T1). It receives blood supply from superficial arch.

      It flexes the metacarpal bone medially across the palm, also rotating it medially, causing opposition, the palmar aspect of the terminal segment of thumb contacts the flexor aspects of any other digit.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 36 - A 24-year-old student with red and painful right eye presents. Conjunctival erythema, mucopurulent...

    Incorrect

    • A 24-year-old student with red and painful right eye presents. Conjunctival erythema, mucopurulent discharge and lid crusting are seen on examination, and patient denies presence of itching of the eye. All his observations are normal, he has no fever and is otherwise well.

      Which of these is the most likely causative organism?

      Your Answer:

      Correct Answer: Haemophilus influenzae

      Explanation:

      The most frequent cause of red eye is conjunctivitis. It is caused by inflammation of the conjunctiva which can be infective or allergic and accounts for about 35% of all eye problems presenting to general practice.

      Viral conjunctivitis is commonly caused by adenoviruses and it is the most common infectious conjunctivitis.

      The common bacterial causes of conjunctivitis are Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.

      The clinical features of infective conjunctivitis include:
      Acute onset of conjunctival erythema
      Feeling ‘grittiness’, ‘foreign body’ or ‘burning’ sensation in the eye.
      Watering and discharge which may cause transient blurring of vision

      The discharge for viral conjunctivitis is less than that of bacterial conjunctivitis and usually watery.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 37 - 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 absolute risk in the Ticagrelor group.

      Your Answer:

      Correct Answer: 0.1

      Explanation:

      The absolute risk (AR) is the probability or chance of an event. It is computed as the number of events in treated or control groups, divided by the number of people in that group.

      AR = 30/300 = 0.1

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds

  • Question 38 - Which of the following is where the rectovesical fascia is located: ...

    Incorrect

    • Which of the following is where the rectovesical fascia is located:

      Your Answer:

      Correct Answer: Between the fundus of the bladder and the ampulla of the rectum

      Explanation:

      In a triangular area between the vasa deferentia, the bladder and rectum are separated only by rectovesical fascia, commonly known as Denonvillier’s fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 39 - Regarding Legionella species which of the following statements is CORRECT: ...

    Incorrect

    • Regarding Legionella species which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: They are Gram-negative organisms.

      Explanation:

      Legionella pneumophilais a Gram negative bacterium that is found in natural water supplies and in the soil, transmitted predominantly via inhalation of aerosols generated from contaminated water (direct person-to-person spread of infected patients does not occur). It is the cause of Legionnaires’ disease. Outbreaks of Legionnaires’ disease have been linked to poorly maintained air conditioning systems, whirlpool spas and hot tubs.

      The clinical features of the pneumonic form of Legionnaires’ disease include:
      Mild flu-like prodrome for 1-3 days
      Cough (usually non-productive and occurs in approximately 90%)
      Pleuritic chest pain
      Haemoptysis
      Headache
      Nausea, vomiting and diarrhoea
      Anorexia
      Legionella pneumophilainfections can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used.
      The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur with Legionnaires’ disease and will result in hyponatraemia as is seen in this case.
      Legionella pneumophilainfections are resistant to amoxicillin but can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used. The majority of cases of Legionnaires’ disease are caused by Legionella pneumophila, however many other species of Legionella have been identified.
      Legionella longbeachae is another less commonly encountered species that has also been implicated in outbreaks. It is predominantly found in soil and potting compost, and has caused outbreaks of Pontiac fever, the non-respiratory and less severe variant of Legionnaires’ disease.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 40 - Superficial fibular nerve palsy results in which of the following clinical features: ...

    Incorrect

    • Superficial fibular nerve palsy results in which of the following clinical features:

      Your Answer:

      Correct Answer: Loss of eversion of the foot

      Explanation:

      Damage to the superficial fibular nerve results in loss of eversion of the foot and loss of sensation over the lower anterolateral leg and the dorsum of the foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 41 - Which of these organisms is commonly spread by droplet transmission? ...

    Incorrect

    • Which of these organisms is commonly spread by droplet transmission?

      Your Answer:

      Correct Answer: Neisseria meningitidis

      Explanation:

      Droplets are airborne particles greater than 5 µm in size. Droplet transmission occurs during talking, coughing and sneezing where respiratory droplets are generated.

      Examples of organisms transmitted by the droplet route include:
      Neisseria meningitidis
      Respiratory syncytial virus
      Parainfluenza virus
      Bordetella pertussis
      Influenza virus

      Poliovirus and Rotavirus are transmitted by the faeco-oral route

      Hepatitis B is transmitted by Sexual route

      Staphylococcus aureus is transmitted by direct contact

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds

  • Question 42 - Which of the following statements about neutrophils is TRUE: ...

    Incorrect

    • Which of the following statements about neutrophils is TRUE:

      Your Answer:

      Correct Answer: Neutrophils are typically the first immune cell to arrive to a site of injury.

      Explanation:

      Neutrophils are the most numerous peripheral blood leukocytes, accounting for 50-70 percent of all circulating white cells. Neutrophils have a compact nucleus with two to five lobes and a pale cytoplasm with an irregular shape containing numerous fine pink-blue or grey-blue granules. The granules are classified as primary, which emerges during the promyelocyte stage, and secondary, which develop at the myelocyte stage and predominate in the mature nucleus.

      The lifespan of neutrophils in the blood is only 6 – 10 hours. In response to tissue damage, cytokines and complement proteins, neutrophils migrate from the bloodstream to the site of insult within minutes, where they destroy pathogens by phagocytosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds

  • Question 43 - Which of the following is NOT an effect of cytokine activity: ...

    Incorrect

    • Which of the following is NOT an effect of cytokine activity:

      Your Answer:

      Correct Answer: Opsonisation of bacteria for phagocytosis

      Explanation:

      Cytokines are a family of chemical messengers, secreted by leucocytes, that act over short distances by binding specific receptors on target cell surfaces. They include: interleukins (act between leucocytes), interferons (inhibit replication of viruses within cells and activate macrophages and natural killer cells), growth factors, and tumour necrosis factors (kill tumour cells). Effects include: induction of fever and acute phase response, stimulation of leucocyte differentiation and maturation, leucocyte recruitment and activation and increased antibody production.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      0
      Seconds

  • Question 44 - Which of the following neurotransmitter and receptor combinations is present at the neuromuscular...

    Incorrect

    • Which of the following neurotransmitter and receptor combinations is present at the neuromuscular junction:

      Your Answer:

      Correct Answer: Acetylcholine acting at nicotinic receptors

      Explanation:

      At the neuromuscular junction, acetylcholine is released from the prejunctional membrane which acts on cholinergic nicotinic receptors on the postjunctional membrane.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 45 - Which of the following is the most abundant peripheral blood leucocyte: ...

    Incorrect

    • Which of the following is the most abundant peripheral blood leucocyte:

      Your Answer:

      Correct Answer: Neutrophils

      Explanation:

      Neutrophils are the most abundant peripheral blood leucocyte, comprising about 50 – 70% of circulating white cells. Neutrophils have a characteristic dense nucleus consisting of between two and five lobes, and a pale cytoplasm with an irregular outline containing many fine pink-blue or grey-blue granules. The granules are divided into primary, which appear at the promyelocyte stage, and secondary, which appear at the myelocyte stage and predominate in the mature nucleus. Both types of granule are lysosomal in origin; the primary contains myeloperoxidase and other acid hydrolases; the secondary contains lactoferrin, lysozyme and other enzymes. The lifespan of neutrophils in the blood is only 6 – 10 hours. In response to tissue damage, cytokines and complement proteins, neutrophils migrate from the bloodstream to the site of insult within minutes, where they destroy pathogens by phagocytosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds

  • Question 46 - Infection with Campylobacter jejuni is one of the most common risk factors for...

    Incorrect

    • Infection with Campylobacter jejuni is one of the most common risk factors for which of the following conditions?

      Your Answer:

      Correct Answer: Guillain-Barre syndrome

      Explanation:

      One of the most common risk factors for GBS is infection with Campylobacter jejuni, which causes diarrhoea.

      Guillain-Barré syndrome (GBS) is a rare autoimmune disorder in which the body’s immune system attacks the nerves, resulting in muscle weakness and paralysis.

      Infection with Streptococcus pyogenes can cause acute glomerulonephritis and rheumatic fever.

      Haemolytic uraemic syndrome is commonly linked to E. coli infection.

      Following measles infection, subacute sclerosing panencephalitis develops.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 47 - The extensor digitorum longus is supplied by which nerve? ...

    Incorrect

    • The extensor digitorum longus is supplied by which nerve?

      Your Answer:

      Correct Answer: Deep peroneal nerve

      Explanation:

      The extensor digitorum longus is innervated by the deep fibular nerve (L5, S1), a branch of the common fibular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 48 - A 58-year-old man with a long history of poorly controlled hypertension complains of...

    Incorrect

    • A 58-year-old man with a long history of poorly controlled hypertension complains of a headache and vision blurring today. In triage, his blood pressure is 210/192 mmHg. A CT head scan is scheduled to rule out the possibility of an intracranial haemorrhage. You make the diagnosis of hypertensive encephalopathy and rush the patient to reus to begin blood pressure-lowering treatment. He has a history of brittle asthma, for which he has been admitted to the hospital twice in the last year.

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

      Your Answer:

      Correct Answer: Nicardipine

      Explanation:

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

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

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

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

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 49 - A somatostatinoma is diagnosed in a 74-year-old patient who has recently developed diabetes...

    Incorrect

    • A somatostatinoma is diagnosed in a 74-year-old patient who has recently developed diabetes mellitus, recurrent episodes of gallstones, and Steatorrhoea. She also  has a tumour in the head of her pancreas.

      Which of the following is the most likely effect of this tumour?

      Your Answer:

      Correct Answer: Inhibit gastric acid secretion

      Explanation:

      Somatostatin-producing cells present in the pyloric antrum, duodenum, and pancreatic islets are known as D-cells or delta-cells. Somatostatin inhibits gastric acid secretion by acting directly on acid-producing parietal cells in the stomach via a G-protein coupled receptor.

      Somatostatin affects hormones in the following ways:
      Inhibits the anterior pituitary’s secretion of growth hormone.
      Inhibits the anterior pituitary’s secretion of thyroid-stimulating hormone.

      The secretion of various gastrointestinal hormones is inhibited (including gastrin, CCK, secretin, motilin, VIP and GIP)

      Reduces the rate at which the stomach empties.
      Inhibits the release of insulin and glucagon from the pancreas.

      The pancreas’ exocrine secretory activity is inhibited.
      Somatostatin can also slow the digestive process by suppressing the production of hormones such gastrin, secretin, and histamine, which reduces gastric acid secretion.

      A somatostatinoma is a cancerous tumour of the endocrine pancreas’ D-cells, which make somatostatin. Somatostatin inhibits pancreatic and gastrointestinal hormones when levels are high. The following clinical characteristics are related with somatostatinomas:

      Insulin secretion blockage causes diabetes mellitus.
      Gallstones by inhibition of CCK and secretin Steatorrhoea via inhibition of CCK and secretin

      Hypochlorhydria is caused by the suppression of gastrin, a hormone that increases gastric acid output regularly.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      0
      Seconds

  • Question 50 - Regarding fibrinolytics, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Fibrinolytic drugs act as thrombolytics by directly degrading the fibrin mesh and so breaking up thrombi.

      Explanation:

      Fibrinolytic drugs act as thrombolytics by activating plasminogen to form plasmin, which degrades fibrin and so breaks up thrombi.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Abdomen (1/2) 50%
Anatomy (5/7) 71%
Microbiology (0/2) 0%
Pathogens (0/1) 0%
Basic Cellular (2/2) 100%
Physiology (4/5) 80%
Cardiovascular Pharmacology (3/4) 75%
Pharmacology (7/8) 88%
Upper Limb (2/3) 67%
Immune Responses (1/1) 100%
Pathology (3/3) 100%
Haematology (2/2) 100%
Endocrine Physiology (1/1) 100%
Head And Neck (1/1) 100%
Evidence Based Medicine (0/3) 0%
Study Methodology (0/1) 0%
Respiratory Pharmacology (2/2) 100%
Abdomen And Pelvis (1/1) 100%
Endocrine (1/1) 100%
CNS Pharmacology (1/1) 100%
Statistics (0/2) 0%
Anaesthesia (1/1) 100%
Specific Pathogen Groups (0/1) 0%
Cardiovascular Physiology (0/1) 0%
Passmed
Retry this test Dashboard