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  • Question 1 - You examine a 48-year-old woman's blood results and notice that her glucose level...

    Incorrect

    • You examine a 48-year-old woman's blood results and notice that her glucose level is elevated. When you tell her about it, she tells you that her doctor recently ran some tests and discovered that she has impaired glucose tolerance.

      Which of the following medications has not been linked to a reduction in glucose tolerance?

      Your Answer: Furosemide

      Correct Answer: Amlodipine

      Explanation:

      The following drugs have been linked to impaired glucose tolerance:
      Thiazide diuretics, e.g. Bendroflumethiazide
      Loop diuretics, e.g. furosemide
      Steroids, e.g. prednisolone
      Beta-blockers, e.g. atenolol

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      177.8
      Seconds
  • Question 2 - 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
      11.8
      Seconds
  • Question 3 - A known epileptic is transported in status epilepticus by ambulance. On the way...

    Incorrect

    • A known epileptic is transported in status epilepticus by ambulance. On the way to the hospital, she took some diazepam.

      Which of the following statements about diazepam is correct?

      Your Answer: It is a short-acting benzodiazepine

      Correct Answer: It crosses into breast milk

      Explanation:

      Diazepam boosts GABA’s effects, giving it sedative, hypnotic, anxiolytic, anticonvulsant, and muscle-relaxing properties. It can be administered orally, rectally, or intravenously.

      With a half-life of 20-100 hours, it is a long-acting benzodiazepine. Midazolam, oxazepam, and alprazolam are examples of short-acting benzodiazepines with a half-life of less than 12 hours (Xanax).

      If used in the presence of hepatic impairment, benzodiazepines can cause coma. If treatment is necessary, benzodiazepines with shorter half-lives should be used in lower doses. Diazepam is a sedative that crosses into breast milk and should be avoided by breastfeeding mothers.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      32.8
      Seconds
  • Question 4 - Which of the following problems is associated with Helicobacter pylori infection? ...

    Correct

    • Which of the following problems is associated with Helicobacter pylori infection?

      Your Answer: Gastric malignancy

      Explanation:

      Helicobacter pylori is a ubiquitous organism that is present in about 50% of the global population. Chronic infection with H pylori causes atrophic and even metaplastic changes in the stomach, and it has a known association with peptic ulcer disease. The most common route of H pylori infection is either oral-to-oral or faecal-to-oral contact.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      379
      Seconds
  • Question 5 - Which of these statements about the monospot test is true? ...

    Incorrect

    • Which of these statements about the monospot test is true?

      Your Answer: It is an example of an indirect Coombs type test

      Correct Answer: It can be positive in rubella

      Explanation:

      Infectious mononucleosis can be diagnosed using specific EBV antibodies and a variety of unrelated non-EBV heterophile antibodies.

      Heterophile antibodies:
      About 70-90% of patients with EBV infectious mononucleosis produce antibodies against an antigen produced in one species that react against antigens from other species called heterophile antibodies. False positives can be seen with rubella, hepatitis, SLE, malaria, toxoplasmosis, lymphoma and leukaemia.

      These antibodies can be detected by two main screening tests:
      The monospot test uses horse red blood cells. It agglutinates in the presence of heterophile antibodies.
      Paul-Bunnell test uses sheep red blood cells. The blood agglutinates in the presence of heterophile antibodies.

      EBV-specific antibodies:
      Patients can remain heterophile-negative after six weeks and are then considered to be heterophile-negative and should be tested for EBV-specific antibodies. EBV-specific antibodies test are helpful if a false positive heterophile antibody test is suspected.
      The indirect Coombs test is used to detect in-vitro antibody-antigen reactions. It is typically used in antenatal antibody screening and in preparation for blood transfusion.
      Heterophile antibody tests are generally not positive in the incubation period of infectious mononucleosis (4-6 weeks) before the onset of symptoms.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      40.7
      Seconds
  • Question 6 - Which of the following is NOT a common side effect of adenosine: ...

    Correct

    • Which of the following is NOT a common side effect of adenosine:

      Your Answer: Yellow vision

      Explanation:

      Common side effects of adenosine include:
      Apprehension
      Dizziness, flushing, headache, nausea, dyspnoea
      Angina (discontinue)
      AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      18.8
      Seconds
  • Question 7 - An elderly man presents with bilateral lower facial swelling around the mandible and...

    Incorrect

    • An elderly man presents with bilateral lower facial swelling around the mandible and upper neck. A CT scan of his neck was performed and the results were conclusive with Ludwig's angina.

      Which of the following spaces is most likely affected based on the case presented?

      Your Answer: Submental space

      Correct Answer: Submandibular space

      Explanation:

      Ludwig’s angina is life-threatening cellulitis of the soft tissue involving the floor of the mouth and neck. It involves three compartments of the floor of the mouth: the sublingual, submental, and submandibular.

      Ludwig’s angina usually originates as a dental infection of the second or third mandibular molars. The infection begins in the subgingival pocket and spreads to the musculature of the floor of the mouth. It progresses below the mylohyoid line, indicating that it has moved to the sublingual space. As the roots of the second and third mandibular molars lie below this line, infection of these teeth will predispose to Ludwig’s angina. The infection spreads lingually rather than buccally because the lingual aspect of the tooth socket is thinner. It initially spreads to the sublingual space and progresses to the submandibular space.

      The disease is usually polymicrobial, involving oral flora, both aerobes, and anaerobes. The most common organisms are Staphylococcus, Streptococcus, Peptostreptococcus, Fusobacterium, Bacteroides, and Actinomyces.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      38.9
      Seconds
  • Question 8 - One of your patients is in resuscitation and is suffering from kidney failure....

    Incorrect

    • One of your patients is in resuscitation and is suffering from kidney failure. The intensive care outreach team arrives to assess them and determines that a dopamine infusion is necessary.

      Dopamine primarily acts on which of the following receptors at low doses?

      Your Answer: Alpha-2 receptors

      Correct Answer: Dopamine receptors

      Explanation:

      Dopamine is a catecholamine that occurs naturally and is used to treat low cardiac output, septic shock, and renal failure. It is both adrenaline and noradrenaline’s immediate precursor.

      Dopamine acts on D1 and D2 dopamine receptors in the renal, mesenteric, and coronary beds at low doses (1-5 g/kg/min). Dopamine causes a significant decrease in renal vascular resistance and an increase in renal blood flow at these doses. Within this dose range, it is also involved in central modulation of behaviour and movement.

      Dopamine stimulates beta- and alpha-adrenergic receptors directly and indirectly at higher doses. Beta-stimulation predominates at a rate of 5-10 g/kg/min, resulting in a positive inotropic effect that increases cardiac output and coronary blood flow. Alpha-stimulation predominates at infusion rates greater than 15 g/kg/min, resulting in peripheral vasoconstriction and an increase in venous return and systolic blood pressure.

      Below is a summary of the mechanisms and effects of various inotropic agents:
      Inotrope
      Mechanism
      Effects
      Adrenaline (epinephrine)
      Beta-1 and -2 agonist at increasing doses;
      Alpha-agonist at high doses
      Increased cardiac output;
      Vasoconstriction at higher doses
      Noradrenaline (norepinephrine)
      Mainly alpha-agonist;
      Beta-1 and -2 agonist at increasing doses
      Vasoconstriction;
      Some increased cardiac output
      Dopamine
      Dopamine agonist at low doses;
      Beta-1 and -2 agonist at increasing doses;
      Alpha-agonist at high doses
      Increased cardiac output;
      Vasoconstriction at higher doses
      Dobutamine
      Mainly beta-1 agonist
      Increased cardiac output

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      28.7
      Seconds
  • Question 9 - Among the following microorganisms, which is considered to be transmitted by invasion of...

    Incorrect

    • Among the following microorganisms, which is considered to be transmitted by invasion of intact skin?

      Your Answer: HIV

      Correct Answer: Leptospira spp.

      Explanation:

      Rodents and domestic animals are the primary reservoirs for the Leptospira spp, although other animals, including cows, horses, mongooses, and frogs, can also harbour the leptospires. Humans may be directly infected from animal urine or indirectly by contact with soil or water that is contaminated with urine from infected animals. Infected humans can shed leptospires in urine for up to 11 months, infected cows for 3.5 months, infected dogs for 4 years, and infected rodents possibly for their entire lifetime.

      The organisms enter the host through mucous membranes or abraded skin. The incubation period ranges from 5 to 14 days.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      20.3
      Seconds
  • Question 10 - Which of the following classes of drugs may predispose to lithium toxicity: ...

    Correct

    • Which of the following classes of drugs may predispose to lithium toxicity:

      Your Answer: Thiazide diuretics

      Explanation:

      Excretion of lithium may be reduced by thiazide diuretics, NSAIDs, and ACE inhibitors thus predisposing to lithium toxicity. Loop diuretics also cause lithium retention but are less likely to result in lithium toxicity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      7.5
      Seconds
  • Question 11 - Regarding Campylobacter gastroenteritis, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding Campylobacter gastroenteritis, which of the following statements is INCORRECT:

      Your Answer: Campylobacter jejuni is primarily responsible.

      Correct Answer: Infection usually requires antibiotic treatment.

      Explanation:

      Campylobacter jejuni is the primary human pathogen, typically causing dysentery (bloody diarrhoea illness) following ingestion of contaminated meat, especially poultry. Infection is typically self-limiting and does not require antibiotic therapy. Campylobacter gastroenteritis is associated with the immune-mediated complications of Guillain-Barre syndrome, reactive arthritis and Reiter’s syndrome.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      35.9
      Seconds
  • Question 12 - Regarding Legionella species which of the following statements is CORRECT: ...

    Correct

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

      Your 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
      14.7
      Seconds
  • Question 13 - Which of the following does NOT increase free ionised calcium levels: ...

    Incorrect

    • Which of the following does NOT increase free ionised calcium levels:

      Your Answer: Parathyroid hormone

      Correct Answer: Calcitonin

      Explanation:

      Calcium homeostasis is primarily controlled by three hormones: parathyroid hormone, activated vitamin D and calcitonin.

      Parathyroid hormone acts on the kidneys to increase calcium reabsorption in the distal tubule by activating Ca2+entry channels in the apical membrane and the Ca2+ATPase pump in the basolateral membrane (and to decrease phosphate reabsorption in the proximal tubule).

      Activated vitamin D acts to increase calcium reabsorption in the distal tubule via activation of a basolateral Ca2+ATPase pump (and to increase phosphate reabsorption).

      Calcitonin acts to inhibit renal reabsorption of calcium (and phosphate).

    • This question is part of the following fields:

      • Physiology
      • Renal
      121.9
      Seconds
  • Question 14 - A 61-year-old man complains of crushing chest pain that radiates to his left...

    Correct

    • A 61-year-old man complains of crushing chest pain that radiates to his left arm and jaw. An ECG is taken, and the lateral leads show extensive ST depression. His blood pressure is currently 190/123 mmHg, and as part of his treatment, you intend to begin drug therapy to lower it.

      Which of the following is the INITIAL drug treatment for this patient's BP reduction?

      Your Answer: Glyceryl trinitrate

      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.

      In the presence of cardiac ischaemia, hypertensive emergencies require immediate treatment to prevent myocardial infarction.

      Similarly, if myonecrosis occurs in the presence of an existing infarction, prompt treatment is required to prevent further myonecrosis. When thrombolysis is used as the primary reperfusion therapy for acute myocardial infarction, blood pressure control is especially important.

      An intravenous nitrate is the drug of choice in this situation (e.g. GTN). These have a dual purpose in that they can help patients with ischaemic chest pain manage their symptoms. Because lowering blood pressure with nitrates isn’t always enough to achieve optimal results, intravenous beta-blockers are frequently used as a supplement. For this, intravenous atenolol and metoprolol are commonly used.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      123.4
      Seconds
  • Question 15 - A 10-year-old girl that appears systemically well presents with a honey-crusted scab close...

    Incorrect

    • A 10-year-old girl that appears systemically well presents with a honey-crusted scab close to the corner of her mouth and states that the area is slightly itchy but not painful. The diagnosis given was impetigo.

      What is most likely the mode of transmission of the causative agent of the said diagnosis?

      Your Answer: Droplet transmission

      Correct Answer: Direct contact

      Explanation:

      Impetigo is a common pyoderma that is most often seen in children. Historically, most cases were caused by group A streptococci (GAS; Streptococcus pyogenes), although S. aureus has become the predominant pathogen over the last 15 years.

      A bullous form of impetigo accounts for approximately 10% of cases. It is caused by strains of S. aureus that produce exfoliative toxins leading to the formation of bullae, which quickly rupture and form a transparent, light brown crust.

      Impetigo is spread mainly by person-to-person contact; it is rapidly spread through direct transmission. The diagnosis of impetigo can be made from a Gram stain and culture of the vesicular contents.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      26.2
      Seconds
  • Question 16 - Regarding platelets, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: Platelets are produced in the bone marrow by fragmentation of the cytoplasm of megakaryocytes.

      Explanation:

      Platelets are produced in the bone marrow by fragmentation of the cytoplasm of megakaryocytes, derived from the common myeloid progenitor cell. The time interval from differentiation of the human stem cell to the production of platelets averages 10 days. Thrombopoietin is the major regulator of platelet formation and 95% of this is produced by the liver. The normal platelet count is approximately 150 – 450 x 109/L and the normal platelet lifespan is 10 days. Under normal circumstances, about one-third of the marrow output of platelets may be trapped at any one time in the normal spleen.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      25
      Seconds
  • Question 17 - Regarding the intervertebral disc, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the intervertebral disc, which of the following statements is CORRECT:

      Your Answer: Herniation of the intervertebral disc occurs when the outer fibrous layer herniates through vertebral bodies.

      Correct Answer: In L4 - L5 disc herniation, the L5 spinal nerve root is the most commonly affected.

      Explanation:

      A posterolateral herniation of the disc at the L4 – L5 level would be most likely to damage the fifth lumbar nerve root, not the fourth lumbar nerve root, due to more oblique descending of the fifth lumbar nerve root within the subarachnoid space.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      42.3
      Seconds
  • Question 18 - Which of the following nerves innervates the adductor brevis? ...

    Incorrect

    • Which of the following nerves innervates the adductor brevis?

      Your Answer: Sciatic nerve

      Correct Answer: Obturator nerve

      Explanation:

      Like the majority of the thigh adductors, adductor brevis is innervated by the obturator nerve. Obturator nerve is derived from the lumbar plexus (anterior branches of spinal nerves L2-L4).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      14.1
      Seconds
  • Question 19 - A 30-year-old carpenter presented to the emergency room with a laceration of his...

    Incorrect

    • A 30-year-old carpenter presented to the emergency room with a laceration of his upper volar forearm. Upon further exploration and observation, it was revealed that the nerve that innervates the pronator teres muscle has been damaged.

      Which of the following nerves is most likely damaged in the case?

      Your Answer: The anterior interosseous nerve

      Correct Answer: The median nerve

      Explanation:

      Pronator teres syndrome (PTS) is caused by a compression of the median nerve (MN) by the pronator teres (PT) muscle in the forearm.

      The median nerve, C6 and C7, innervates the pronator teres.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      41.2
      Seconds
  • Question 20 - The functional residual capacity (FRC) will be increased in which of the following:...

    Incorrect

    • The functional residual capacity (FRC) will be increased in which of the following:

      Your Answer: Pregnancy

      Correct Answer: Emphysema

      Explanation:

      Factors increasing FRC:
      Emphysema
      Air trapping in asthma
      Ageing (due to loss of elastic properties)
      Increasing height of patient

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      20.2
      Seconds
  • Question 21 - Which of the following is NOT a typical feature of benzodiazepine toxicity: ...

    Correct

    • Which of the following is NOT a typical feature of benzodiazepine toxicity:

      Your Answer: Hyperventilation

      Explanation:

      Features of benzodiazepine toxicity include: drowsiness, ataxia, dysarthria, nystagmus, occasionally respiratory depression and coma

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      11
      Seconds
  • Question 22 - A 49-year-old woman has a history of hypertension and persistent hypokalaemia and is...

    Incorrect

    • A 49-year-old woman has a history of hypertension and persistent hypokalaemia and is diagnosed with hyperaldosteronism.

      Which of these is the commonest cause of hyperaldosteronism?

      Your Answer: Familial aldosteronism

      Correct Answer: Adrenal adenoma

      Explanation:

      When there are excessive circulating levels of aldosterone, hyperaldosteronism occurs. There are two main types of hyperaldosteronism:

      Primary hyperaldosteronism (,95% of cases)
      Secondary hyperaldosteronism (,5% of cases)

      Primary causes of hyperaldosteronism include:
      Adrenal adenoma (Conn’s syndrome)
      Adrenal hyperplasia
      Adrenal cancer
      Familial aldosteronism
      Secondary causes of hyperaldosteronism include:
      Drugs
      Obstructive renal artery disease
      Renal vasoconstriction
      Oedematous disorders syndrome

      Adrenal adenoma is the commonest cause of hyperaldosteronism (seen in ,80% of all cases).

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      9.2
      Seconds
  • Question 23 - Which of the following is NOT one of the cardinal features of acute...

    Correct

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

      Your 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
      8.9
      Seconds
  • Question 24 - A 70-year-old patient diagnosed with Cushing's syndrome, has a history of weight gain,...

    Incorrect

    • A 70-year-old patient diagnosed with Cushing's syndrome, has a history of weight gain, hypertension, and easy bruising.

      Which of the following statements about Cushing's syndrome is NOT true?

      Your Answer: Diagnosis can be confirmed by a 24-hour urinary free cortisol collection

      Correct Answer: Menorrhagia is a common feature

      Explanation:

      Cushing’s syndrome is a group of symptoms and signs brought on by long-term exposure to high amounts of endogenous or exogenous glucocorticoids.

      Iatrogenic corticosteroid injection is the most prevalent cause of Cushing’s syndrome.
      Cortisol levels fluctuate throughout the day, with the greatest levels occurring around 0900 hours and the lowest occurring at 2400 hrs during sleep. The diurnal swing of cortisol levels is lost in Cushing’s syndrome, and levels are greater throughout the 24-hour period. In the morning, levels may be normal, but they may be high at night-time, when they are generally repressed.

      Insulin resistance causes hyperglycaemia, which is a frequent symptom. Insulin resistance can produce acanthosis nigricans in the axilla and around the neck, as well as other skin abnormalities.

      In contrast to menorrhagia, elevated testosterone levels are more likely to produce amenorrhoea or oligomenorrhoea. Infertility in women of reproductive age can also be caused by high androgen levels.

      A dexamethasone suppression test or a 24-hour urine free cortisol collection can both be used to establish the existence of Cushing’s syndrome.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      30
      Seconds
  • Question 25 - What does the correlation coefficient r = 0 indicate with regards to linear...

    Correct

    • What does the correlation coefficient r = 0 indicate with regards to linear relationships between two variables?

      Your Answer: There is no correlation between two variables

      Explanation:

      r = 0 if there is no correlation between two variables.
      The closer that r is to 0, the weaker the correlation.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      47.4
      Seconds
  • Question 26 - A 35-year-old man suffers an open fracture of his forearm. The nerve that...

    Correct

    • A 35-year-old man suffers an open fracture of his forearm. The nerve that innervates the pronator quadratus muscle is damaged as a consequence of this injury.
      Which of the following nerves has been damaged in this case? Select ONE answer only.

      Your Answer: The anterior interosseous nerve

      Explanation:

      Pronator quadratus is a small, square-shaped muscle that lies in the anterior compartment of the forearm. It arises from the distal fourth of the anterior surface of the ulna and inserts into the distal fourth of the anterior surface of the radius.
      Pronator quadratus is innervated by the anterior interosseous nerve. It receives its blood supply from the anterior interosseous artery, which is a branch of the common interosseous artery, which in turn is a branch of the ulnar artery.
      The main action of pronator quadratus is to assist pronator teres with pronation of the forearm. The deep fibres bind the radius and ulna together.
      The pronator quadratus muscle highlighted in blue (adapted from Gray’s Anatomy)

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.5
      Seconds
  • Question 27 - Which of the following statements accurately describes the flexor digitorum superficialis muscle? ...

    Incorrect

    • Which of the following statements accurately describes the flexor digitorum superficialis muscle?

      Your Answer: It has a point of origin on the lateral epicondyle of the humerus

      Correct Answer: It flexes the middle phalanges of the medial four fingers at the proximal interphalangeal joints

      Explanation:

      Flexor digitorum superficialis is the largest muscle of the anterior compartment of the forearm. It belongs to the superficial flexors of the forearm, together with pronator teres, flexor carpi radialis, flexor carpi ulnaris and palmaris longus. Some sources alternatively classify this muscle as an independent middle/intermediate layer of the anterior forearm, found between the superficial and deep groups.

      Flexor digitorum superficialis is innervated by muscular branches of the median nerve, derived from roots C8 and T1 that arises from the medial and lateral cords of the brachial plexus. The skin that overlies the muscle is supplied by roots C6-8 and T1.

      The primary arterial blood supply to the flexor digitorum superficialis is derived from the ulnar artery and its anterior recurrent branch. In addition to branches of the ulnar artery, the anterior and lateral surfaces of the muscle are supplied by branches of the radial artery; and its posterior surface also receives branches from the median artery.

      The main function of flexor digitorum superficialis is flexion of the digits 2-5 at the proximal interphalangeal and metacarpophalangeal joints. Unlike the flexor digitorum profundus, flexor digitorum superficialis has independent muscle slips for all four digits. This allows it to flex the digits individually at their proximal interphalangeal joints. In addition, flexor digitorum superficialis aids the aids flexion of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      70.2
      Seconds
  • Question 28 - A 29-year-old female with chronic anaemia secondary to sickle cell disease is being...

    Incorrect

    • A 29-year-old female with chronic anaemia secondary to sickle cell disease is being transfused. A few minutes after starting the blood transfusion, she develops widespread itching with urticarial rash, wheezing, nausea and chest pain. Her BP reduces to 60/40 mmHg.

      What is the most appropriate treatment?

      Your Answer: Slow the transfusion rate and administer antihistamines

      Correct Answer: Stop the transfusion and administer adrenaline

      Explanation:

      Anaphylaxis transfusion reaction occurs when an individual has previously been sensitized to an allergen present in the blood and, on re-exposure, releases IgE or IgG antibodies. Patients with anaphylaxis usually develop laryngospasm, bronchospasm, abdominal pain, nausea, vomiting, hypotension, shock, and loss of consciousness. The transfusion should be stopped immediately and the patient should be treated with adrenaline, oxygen, corticosteroids, and antihistamines.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      39.1
      Seconds
  • Question 29 - The qSOFA score is a bedside prompt designed to identify patients with suspected...

    Incorrect

    • The qSOFA score is a bedside prompt designed to identify patients with suspected infection who are at greater risk for a poor outcome outside of the intensive care unit.
      Which of the following is one of the criteria used in the qSOFA score? Select ONE answer only.

      Your Answer: Temperature >38°C

      Correct Answer: Respiratory rate >22

      Explanation:

      In February 2016 the Society of Critical Care Medicine published a JAMA article reformatting the definitions of sepsis in an attempt to overcome the shortcomings of the old definitions.
      The main changes are a new definition of sepsis, the replacement of the SIRS criteria with the quick Sepsis-related Organ Failure Assessment (qSOFA), and the complete removal of “severe sepsis” as an entity.
      The new definition of sepsis is that it is “life-threatening organ dysfunction caused by a dysregulated host response to infection.”
      Septic shock is “a subset of sepsis in which underlying circulatory and cellular metabolism abnormalities are profound enough to increase mortality.”
      In essence this means that septic shock is sepsis plus the following, despite adequate fluid resuscitation:
      Vasopressors required to maintain a MAP > 65 mmHg
      Serum lactate > 2 mmol/l
      The qSOFA score is a bedside prompt designed to identify patients with suspected infection who are at greater risk for a poor outcome outside of the intensive care unit. It uses the following three criteria:
      Hypotension (SBP < 100 mmHg)
      Tachypnoea (RR > 22)
      Altered mental status (GCS < 15)
      The presence of 2 or more of the qSOFA criteria near the onset of infection is associated with greater risk of death or a prolonged intensive care unit stay.

    • This question is part of the following fields:

      • Pathology
      • Pathology Of Infections
      21.6
      Seconds
  • Question 30 - Which of the following immunoglobulins is predominant in saliva: ...

    Correct

    • Which of the following immunoglobulins is predominant in saliva:

      Your Answer: IgA

      Explanation:

      Immunoglobulin A is predominant in saliva.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      8.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular Pharmacology (1/3) 33%
Pharmacology (4/7) 57%
Evidence Based Medicine (1/2) 50%
Statistics (1/2) 50%
CNS Pharmacology (0/1) 0%
Microbiology (2/6) 33%
Pathogens (2/3) 67%
Specific Pathogen Groups (0/1) 0%
Cardiovascular (1/1) 100%
Anatomy (1/6) 17%
Head And Neck (0/2) 0%
Principles Of Microbiology (0/2) 0%
Central Nervous System (1/1) 100%
Physiology (2/6) 33%
Renal (0/1) 0%
Basic Cellular (1/1) 100%
Lower Limb (0/1) 0%
Upper Limb (1/3) 33%
Respiratory (0/1) 0%
Anaesthesia (1/1) 100%
Endocrine Physiology (0/2) 0%
Inflammatory Responses (1/1) 100%
Pathology (1/3) 33%
Haematology (0/1) 0%
Pathology Of Infections (0/1) 0%
Gastrointestinal (1/1) 100%
Passmed