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Question 1
Correct
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A 66-year-old female who is a known case of atrial fibrillation comes to the Emergency Department with the complaint of fever and vomiting for the past two days. When her medical chart is reviewed, you see that she takes Warfarin for her arrhythmia.
Which ONE of the following medications cannot be prescribed to this patient?Your Answer: Ibuprofen
Explanation:Like other non-steroidal anti-inflammatory drugs, Ibuprofen cannot be given with Warfarin as it would increase the bleeding risk of this patient.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 2
Correct
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You are taking care of a 55-year-old male patient with a direct inguinal hernia. In explaining his hernia, which of the following layers was compromised and had resulted in his condition?
Your Answer: Transversalis fascia
Explanation:Direct inguinal hernias are most often caused by a weakness in the muscles of the abdominal wall that develops over time, or are due to straining or heavy lifting.
A direct inguinal hernia protrudes through the Transversalis fascia.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 3
Correct
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A 23-year-old man is discovered to have an infection from Helicobacter pylori.
Which of the following types of cancer is mostly associated with Helicobacter pylori infection?Your Answer: Gastric cancer
Explanation:H. pylori is recognized as a major cause of type B gastritis, a chronic condition formerly associated primarily with stress and chemical irritants. In addition, the strong association between long-term H. pylori infection and gastric cancer has raised more questions regarding the clinical significance of this organism. There is speculation that long-term H. pylori infection resulting in chronic gastritis is an important risk factor for gastric carcinoma resulting in H. pylori being classified as a carcinogen.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 4
Correct
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Regarding penicillin antibiotics, which of the following statements is CORRECT:
Your Answer: Patients with a history of atopy are at higher risk of hypersensitivity reactions.
Explanation:Allergic reactions to penicillins occur in 1 – 10% of exposed individuals; anaphylactic reactions occur in fewer than 0.05% of treated patients. Patients with a history of atopic allergy are at higher risk of anaphylactic reactions to penicillins. Patients with a history of anaphylaxis, urticaria, or rash immediately after penicillin use should not receive a penicillin or other beta-lactam antibiotics; about 0.5 – 6.5 % of penicillin-sensitive patients will also be allergic to the cephalosporins.
Patients with a history of a more minor rash (i.e. non-confluent, non-pruritic rash restricted to a small area of the body) or delayed reaction (rash occurring more than 72 hours after penicillin administration), may not be truly allergic and may be considered for penicillin or beta-lactam treatment in severe infection (although possibility of allergy should be borne in mind). Other beta-lactam antibiotics (including cephalosporins) can be used in these patients.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 5
Correct
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A patient with history of weight loss and diarrhoea was found out to have Giardia lamblia in her stool since returning from a holiday to Nepal.
Which of the following statements is considered true regarding the life cycle of Giardia lamblia?Your Answer: Trophozoites attach to the intestinal wall via a specialised sucking disc
Explanation:Cysts are resistant forms and are responsible for transmission of giardiasis. Both cysts and trophozoites can be found in the faeces (diagnostic stages). The cysts are hardy and can survive several months in cold water. Infection occurs by the ingestion of cysts in contaminated water, food, or by the faecal-oral route (hands or fomites).
In the small intestine, excystation releases trophozoites (each cyst produces two trophozoites).
Trophozoites multiply by longitudinal binary fission, remaining in the lumen of the proximal small bowel where they can be free or attached to the mucosa by a ventral sucking disk.
Encystation occurs as the parasites transit toward the colon. The cyst is the stage found most commonly in non diarrheal faeces.
Because the cysts are infectious when passed in the stool or shortly afterward, person-to-person transmission is possible. While animals are infected with Giardia, their importance as a reservoir is unclear. -
This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 6
Correct
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A type II error occurs when:
Your Answer: The null hypothesis is accepted when it is false.
Explanation:A type II error occurs when the null hypothesis is wrongly accepted when it is actually false and we conclude that there is no evidence of a difference in effect when one really exists (a false negative result).
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 7
Incorrect
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A 40-year-old man has been admitted for alcohol detoxification. You are asked to review the patient's treatment chart and notice that he has been prescribed Pabrinex by one of your colleagues.
Out of the following, which vitamin is not found in Pabrinex?Your Answer: Vitamin B3
Correct Answer: Vitamin B12
Explanation:Pabrinex is indicated in patients that require rapid therapy for severe depletion or malabsorption of water-soluble vitamins B and C, particularly in alcoholism detoxification.
Pabrinex has the following:
1. Thiamine (vitamin B1)
2. Riboflavin (vitamin B2)
3. Nicotinamide (Vitamin B3, niacin and nicotinic acid)
4. Pyridoxine (vitamin B6)
5. Ascorbic acid (vitamin C)
6. GlucoseSuspected or established Wernicke’s encephalopathy is treated by intravenous infusion of Pabrinex/ The dose is 2-3 pairs three times a day for three to five days, followed by one pair once daily for an additional three to five days or for as long as improvement continues.
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This question is part of the following fields:
- Fluids & Electrolytes
- Pharmacology
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Question 8
Correct
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The following all cause a right shift in the oxygen dissociation curve EXCEPT for:
Your Answer: Foetal haemoglobin
Explanation:A decreased affinity of haemoglobin for oxygen (and hence increased ease of dissociation), shown by a right shift in the oxygen dissociation curve, is caused by a fall in pH, a rise in PCO2(the Bohr effect) and an increase in temperature. These changes occur in metabolically active tissues such as in exercise, and encourage oxygen release. The metabolic by-product 2,3-diphosphoglycerate (2,3 -DPG) also causes a right shift; 2, 3 -DPG may also be raised in chronic anaemia, chronic lung disease, or at high altitude. Foetal haemoglobin (HbF) binds 2, 3 -DPG less strongly than does adult haemoglobin (HbA), and so the HbF dissociation curve lies to the left of that for HbA, reflecting its higher oxygen affinity. This helps transfer oxygen from mother to foetus.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 9
Correct
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Dexamethasone would be most useful for which of the following conditions:
Your Answer: Raised intracranial pressure secondary to malignancy
Explanation:Dexamethasone has a very high glucocorticoid activity in conjunction with insignificant mineralocorticoid activity. This makes it particularly suitable for high-dose therapy in conditions where fluid retention would be a disadvantage such as in the management of raised intracranial pressure or cerebral oedema secondary to malignancy. Dexamethasone also has a long duration of action and this, coupled with its lack of mineralocorticoid action makes it particularly suitable for suppression of corticotropin secretion in congenital adrenal hyperplasia. In most individuals a single dose of dexamethasone at night, is sufficient to inhibit corticotropin secretion for 24 hours. This is the basis of the ‘overnight dexamethasone suppression test’ for diagnosing Cushing’s syndrome.
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This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 10
Incorrect
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A 53 year old women presents to the emergency room with a chronic cough. The pulmonary receptors likely to be involved in causing her cough are:
Your Answer: Juxtapulmonary (J) receptors
Correct Answer: Irritant receptors
Explanation:Throughout the airways, there are irritant receptors which are located between epithelial cells which are made of rapidly adapting afferent myelinated fibres in the vagus nerve. A cough is as a result of receptor stimulation located in the trachea, hyperpnoea is as a result of receptor stimulation in the lower airway. Stimulation may also result in reflex bronchial and laryngeal constriction. Many factors can stimulate irritant receptors. These include irritant gases, smoke and dust, airway deformation, pulmonary congestion, rapid inflation/deflation and inflammation. Deep augmented breaths or sighs seen every 5 – 20 minutes at rest are due to stimulation of these irritant receptors. This reverses the slow lung collapse that occurs in quiet breathing.
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This question is part of the following fields:
- Physiology
- Respiratory
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SESSION STATS - PERFORMANCE PER SPECIALTY
