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  • Question 1 - Regarding threadworms, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: First line treatment of threadworms is with mebendazole.

      Explanation:

      First line treatment of threadworms is with mebendazole, with treatment of the whole family, and a repeat treatment after 2 weeks. Threadworms live in the large bowel, but direct multiplication of worms does not occur here. Threadworms most commonly infect children, and may be symptomatic or cause pruritus ani.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      63.2
      Seconds

  • Question 2 - An ambulance transports a 37-year-old woman who is having a seizure. She is...

    Correct

    • An ambulance transports a 37-year-old woman who is having a seizure. She is moved to resuscitation and given a benzodiazepine dose, which quickly ends the seizure. You later learn that she has epilepsy and is usually treated with carbamazepine to control her seizures.

      What is carbamazepine's main mechanism of action?

      Your Answer: Sodium channel blocker

      Explanation:

      Carbamazepine is primarily used to treat epilepsy, and it is effective for both focal and generalised seizures. It is not, however, effective in the treatment of absence or myoclonic seizures. It’s also commonly used to treat neuropathic pain, as well as a second-line treatment for bipolar disorder and as a supplement for acute alcohol withdrawal.

      Carbamazepine works as a sodium channel blocker that preferentially binds to voltage-gated sodium channels in their inactive state. This prevents an action potential from firing repeatedly and continuously.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      457.1
      Seconds

  • Question 3 - Which of the following statements is correct with regards to immunoglobulin? ...

    Incorrect

    • Which of the following statements is correct with regards to immunoglobulin?

      Your Answer: Each immunoglobulin molecule has one kappa light chain and one delta light chain.

      Correct Answer: The isotype of immunoglobulin is determined by the heavy chain.

      Explanation:

      The composition of immunoglobulin molecules is two identical heavy and two identical light chains. These chains are linked by disulphide bridges and are each have highly variable regions which give the immunoglobulin its specificity. In addition, they have constant regions and there is virtual complete correspondence in amino acid sequence in all antibodies of a given isotype.
      Five isotypes of immunoglobulin exist – these are IgG, IgA, IgM, IgE and IgD. They are determined by the heavy chain (gamma, alpha, mu, epsilon or delta respectively). The light chains are either kappa or lambda.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      66.2
      Seconds

  • Question 4 - What is the partial pressure of oxygen if it makes up 20.9 percent...

    Correct

    • What is the partial pressure of oxygen if it makes up 20.9 percent of the ambient air composition and the atmospheric pressure of ambient air is 760 mmHg?

      Your Answer: 159 mmHg

      Explanation:

      Ambient air is atmospheric air in its natural state. Ambient air is typically 78.6% nitrogen and 20.9% oxygen. The extra 1% is made up of carbon, helium, methane, argon and hydrogen.

      The partial pressure of any gas can be calculated using this formula: P = atmospheric pressure (760 mmHg) x percent content in the mixture.

      Atmospheric pressure is the sum of all of the partial pressures of the atmospheric gases added together: The formula for atmospheric pressure is: Patm = PN2 + PO2 + PH2O + PCO2. The atmospheric pressure is known to be 760 mmHg.

      The partial pressures of the various gases can be estimated to have partial pressures of approximately 597.4 mmHg for nitrogen, 158.8 mm Hg for oxygen, and 7.6 mmHg for argon.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      140.3
      Seconds

  • Question 5 - A patient sustains an injury to the proximal median nerve after falling through...

    Incorrect

    • A patient sustains an injury to the proximal median nerve after falling through a glass door. Which of the following muscles would you not expect to be affected:

      Your Answer: Flexor digitorum profundus

      Correct Answer: Flexor carpi ulnaris

      Explanation:

      All of the muscles in the anterior forearm are innervated by the median nerve, except for the flexor carpi ulnaris and the medial half of the flexor digitorum profundus which are innervated by the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      195.7
      Seconds

  • Question 6 - Regarding drug interactions with erythromycin, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding drug interactions with erythromycin, which of the following statements is INCORRECT:

      Your Answer: Erythromycin increases plasma levels of carbamazepine.

      Correct Answer: Erythromycin decreases plasma levels of warfarin.

      Explanation:

      Erythromycin and clarithromycin inhibit cytochrome P450-mediated metabolism of warfarin, phenytoin and carbamazepine and may lead to accumulation of these drugs. There is an increased risk of myopathy (due to cytochrome P450 enzyme CYP3A4 inhibition) if erythromycin or clarithromycin is taken with atorvastatin or simvastatin. Erythromycin increases plasma concentrations of theophylline, and theophylline may also reduce absorption of oral erythromycin. All macrolides can prolong the QT-interval and concomitant use of drugs that prolong the QT interval is not recommended.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      312.1
      Seconds

  • Question 7 - Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Ca 2+ is transported out of the cell predominantly by Ca 2+ ATPase.

      Correct Answer: The Treppe effect refers to an increase in contractility secondary to an increase in heart rate.

      Explanation:

      Although Ca2+entry during the action potential (AP) is essential for contraction, it only accounts for about 25% of the rise in intracellular Ca2+. The rest is released from Ca2+stores in the sarcoplasmic reticulum (SR). In relaxation, about 80% of Ca2+is rapidly pumped back into the SR (sequestered) by Ca2+ATPase pumps. The Ca2+that entered the cell during the AP is transported out of the cell primarily by the Na+/Ca2+exchanger in the membrane. When more action potentials occur per unit time, more Ca2+enters the cell during the AP plateau, more Ca2+is stored in the SR, more Ca2+is released from the SR and thus more Ca2+is left inside the cell and greater tension is produced during contraction. Increased heart rate increases the force of contraction in a stepwise fashion as intracellular [Ca2+] increases cumulatively over several beats; this is the Treppe effect. Cardiac glycosides such as digoxin have a positive inotropic effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      136.6
      Seconds

  • Question 8 - 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: Levetiracetam

      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
      36.2
      Seconds

  • Question 9 - A 58-year-old woman presents with symptoms of increase in weight, proximal muscular weakening...

    Incorrect

    • A 58-year-old woman presents with symptoms of increase in weight, proximal muscular weakening and withering, easy bruising, and acne. You notice that she has a full, plethoric aspect to her face, as well as significant supraclavicular fat pads, when you examine her. She has previously been diagnosed with Cushing's syndrome.

      Which of the following biochemical profiles best supports this diagnosis?

      Your Answer: Hyperkalaemic metabolic alkalosis

      Correct Answer: Hypokalaemic metabolic alkalosis

      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. Cushing’s syndrome affects about 10-15 persons per million, and it is more common in those who have had a history of obesity, hypertension, or diabetes.

      A typical biochemical profile can help establish a diagnosis of Cushing’s syndrome. The following are the primary characteristics:
      Hypokalaemia
      Alkalosis metabolique

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      18.5
      Seconds

  • Question 10 - A 36-year-old man presented to the emergency room after an incident of slipping...

    Correct

    • A 36-year-old man presented to the emergency room after an incident of slipping and falling onto his back and left hip. Upon physical examination, it was noted that he has pain on hip extension, but normal hip abduction.

      Which of the following muscles was most likely injured in this case?

      Your Answer: Gluteus maximus

      Explanation:

      The primary hip extensors are the gluteus maximus and the hamstrings such as the long head of the biceps femoris, the semitendinosus, and the semimembranosus. The extensor head of the adductor magnus is also considered a primary hip extensor.

      The hip abductor muscle group is located on the lateral thigh. The primary hip abductor muscles include the gluteus medius, gluteus minimus, and tensor fasciae latae.
      The secondary hip abductors include the piriformis, sartorius, and superior fibres of the gluteus maximus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      47
      Seconds

  • Question 11 - In which of the following would you NOT typically see a neutropaenia: ...

    Incorrect

    • In which of the following would you NOT typically see a neutropaenia:

      Your Answer: Chloramphenicol therapy

      Correct Answer: Asplenism

      Explanation:

      Causes of neutropaenia:
      Drug-induced (e.g. chemotherapy, chloramphenicol, co-trimoxazole, phenytoin, carbamazepine, carbimazole, furosemide, chloroquine, clozapine, some DMARDs)
      Benign (racial or familial)
      Cyclical
      Immune (e.g. SLE, Felty’s syndrome, hypersensitivity and anaphylaxis)
      Leukaemia
      Infections (e.g. HIV, hepatitis, fulminant bacterial infection)
      General Pancytopaenia
      Hypersplenism, aplastic anaemia, malignant infiltration of bone marrow, megaloblastic anaemia, chemotherapy, myelodysplasia

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      37.5
      Seconds

  • Question 12 - All of the following statements are considered true regarding nominal variables, except: ...

    Incorrect

    • All of the following statements are considered true regarding nominal variables, except:

      Your Answer: They are categorical variables

      Correct Answer: The central tendency of a nominal variable is given by its median

      Explanation:

      A nominal variable is a type of variable that is used to name, label or categorize particular attributes that are being measured. It takes qualitative values representing different categories, and there is no intrinsic ordering of these categories.
      A nominal variable is one of the 2 types of categorical variables and is the simplest among all the measurement variables. Some examples of nominal variables include gender, name, phone, etc.

      A nominal variable is qualitative, which means numbers are used here only to categorize or identify objects. They can also take quantitative values. However, these quantitative values do not have numeric properties. That is, arithmetic operations cannot be performed on them. If the variable is nominal, the mode is the only measure of central tendency to use.

    • This question is part of the following fields:

      • Evidence Based Medicine
      19
      Seconds

  • Question 13 - Regarding calcium handling by the kidneys, which of the following statements is CORRECT:...

    Correct

    • Regarding calcium handling by the kidneys, which of the following statements is CORRECT:

      Your Answer: Activated vitamin D upregulates Ca 2+ ATPase pumps in the distal tubule.

      Explanation:

      Calcium that is not protein bound is freely filtered in the glomerulus, and there is reabsorption along the nephron.About 70% is reabsorbed in the proximal tubule.About 20% is reabsorbed in the thick ascending limb of the loop of Henle.This reabsorption is mainly passive and paracellular and driven by sodium reabsorption. Sodium reabsorption causes water reabsorption, which raises tubular calcium concentration, causing calcium to diffuse out of the tubules. The positive  lumen potential also encourages calcium to leave the tubule.About 5 – 10% is reabsorbed in the distal convoluted tubule.Less than 0.5% is reabsorbed in the collecting ducts.Calcium reabsorption in the distal nephron is active and transcellular and is the major target for hormonal control.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
      19
      Seconds

  • Question 14 - A patient has a cardiac output of 4.8 L/min and a heart rate...

    Correct

    • A patient has a cardiac output of 4.8 L/min and a heart rate of 80 bpm, therefore their stroke volume is:

      Your Answer: 60 mL

      Explanation:

      Cardiac output (CO) = Stroke volume (SV) x Heart rate (HR).
      Therefore SV = CO/HR
      = 4.8/80
      = 0.06 L = 60 mL.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      53.5
      Seconds

  • Question 15 - Which of the following pathogens is most likely to cause an infection in...

    Correct

    • Which of the following pathogens is most likely to cause an infection in a chemo patient with significant neutropenia?

      Your Answer: Candida

      Explanation:

      Chemotherapy that is too aggressive weakens your immune system, putting you at risk for a fungal and many other infection.

      Neutropenia is a condition in which a person’s neutrophil count is abnormally low. Neutrophils are an infection-fighting type of white blood cell. Neutrophils fight infection by killing bacteria and fungi (yeast) that infiltrate the body.

      Fungal organisms are significant pathogens in the setting of neutropenia.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      10.4
      Seconds

  • Question 16 - A 57-year-old woman has presented with cough and shortness of breath. Her GP...

    Incorrect

    • A 57-year-old woman has presented with cough and shortness of breath. Her GP had done some blood tests recently and told her that she had a positive ANA result.

      Which of these statements is true about anti-nuclear antibodies (ANAs)? Select only ONE answer.

      Your Answer: ELISA testing is the most accurate means of testing for ANAs.

      Correct Answer: The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome

      Explanation:

      Anti-nuclear antibodies are auto-antibodies directed against a variety of nuclear antigens. There are different staining patterns and each pattern is suggestive of a different disorder.

      Speckled staining is suggestive of mixed connective tissue disease.

      Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.

      Anti-double stranded DNA is suggestive of SLE while anti-histone antibodies are suggestive of drug-induced lupus.

      ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most accurate.

      The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome. Felty’s syndrome is characterized by a combination of rheumatoid arthritis, splenomegaly and neutropenia.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      124.2
      Seconds

  • Question 17 - Anatomical barriers to infection include all of the following EXCEPT: ...

    Incorrect

    • Anatomical barriers to infection include all of the following EXCEPT:

      Your Answer: Flushing action of tears

      Correct Answer: Mucociliary escalator in the gastrointestinal tract

      Explanation:

      Anatomical barriers to infection include:tight junctions between cells of the skin and mucosal membranesthe flushing action of tears, saliva and urinethe mucociliary escalator in the respiratory tract (together with the actions of coughing and sneezing)the acidic pH of gastric and vaginal secretionsthe acidic pH of the skin (maintained by lactic acid and fatty acids in sebum)enzymes such as lysozyme found in saliva, sweat and tearspepsin present in the stomachbiological commensal flora formed on the skin and the respiratory, gastrointestinal and genitourinary tracts which protect the host by competing with pathogenic bacteria for nutrients and attachment sites and by producing antibacterial substances

    • This question is part of the following fields:

      • Microbiology
      • Principles
      20.2
      Seconds

  • Question 18 - Dysuria and urinary frequency are symptoms of a 29-year-old woman. A urine dipstick...

    Incorrect

    • Dysuria and urinary frequency are symptoms of a 29-year-old woman. A urine dipstick is used to detect the presence of blood, protein, leucocytes, and nitrites in the urine. You diagnose a urinary tract infection and give antibiotics to the patient.

      In the United Kingdom, which of the following antibiotics has the highest percentage of E.coli resistance?

      Your Answer:

      Correct Answer: Trimethoprim

      Explanation:

      In the United Kingdom, antibiotic resistance is becoming a significant factor in the treatment of urinary tract infections and pyelonephritis. E. coli (the main causative organism of both urinary tract infections and acute pyelonephritis) resistance to the following antibiotics in laboratory-processed urine specimens is:
      30.3 percent trimethoprim (varies by area from 27.1 to 33.4 percent )
      19.8 percent co-amoxiclav (varies by area from 10.8 to 30.7 percent )
      Ciprofloxacin (Cipro): 10.6% (varies by area from 7.8 to 13.7 percent )
      Cefalexin has a concentration of 9.9%. (varies by area from 8.1 to 11.4 percent )

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 19 - The causative organism for an infection in a patient you are reviewing...

    Incorrect

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

      Which of these is a facultative anaerobic organism?

      Your Answer:

      Correct Answer: Staphylococcus aureus

      Explanation:

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

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

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

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

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds

  • Question 20 - C5 - C9 deficiency increases susceptibility to infection with which of the following:...

    Incorrect

    • C5 - C9 deficiency increases susceptibility to infection with which of the following:

      Your Answer:

      Correct Answer: Neisseria spp.

      Explanation:

      If the complement sequence is completed, an active phospholipase (the membrane attack complex, MAC) is produced, which punches holes in the cell membrane and causes cell lysis. Because the MAC appears to be the sole means to destroy the Neisseria family of bacteria, C5 – C9 deficiency increases susceptibility to Neisseria infections.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds

  • Question 21 - A 22-year-old with a history of brittle asthma is brought to the ED...

    Incorrect

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

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

      Your Answer:

      Correct Answer: Ketamine

      Explanation:

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

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

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

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

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds

  • Question 22 - Which of the following is NOT an advantage of a cohort study used...

    Incorrect

    • Which of the following is NOT an advantage of a cohort study used to investigate the relationship between exposure to a risk factor and a future outcome:

      Your Answer:

      Correct Answer: Particularly suitable for rare diseases

      Explanation:

      Advantages: ideal for studying associations between an exposure and an outcome when the exposure is uncommon, the time sequence of events can be assessed, they can provide information on a wide range of disease outcomes, the absolute and relative risk of disease can be measured directly, they can give a direct estimation of disease incidence rates
      Disadvantages: costly and can take long periods of time if the outcome is delayed, subject to subject-selection and loss to follow-up bias, large sample size required for rare outcome of interest so it is not useful for rare diseases, prone to confounding

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      0
      Seconds

  • Question 23 - During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate is...

    Incorrect

    • During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate is born with bilateral deafness as a result of this.

      From the  following antibiotics, which one is most likely to cause this side effect?

      Your Answer:

      Correct Answer: Gentamicin

      Explanation:

      Aminoglycosides cross the placenta and are linked to poisoning of the 8th cranial nerve in the foetus, as well as permanent bilateral deafness.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 24 - A young man develops an infection spread via aerosol transmission.

    Which of these organisms...

    Incorrect

    • A young man develops an infection spread via aerosol transmission.

      Which of these organisms is commonly spread by aerosol transmission?

      Your Answer:

      Correct Answer: Measles virus

      Explanation:

      Aerosols are airborne particles less than 5 µm in size, containing infective organisms that usually cause infection of the upper or lower respiratory tract.

      Examples of organisms commonly spread by aerosol transmission are:
      Measles virus
      Varicella zoster virus
      Mycobacterium tuberculosis

      The following table summarises the various routes of transmission with example organisms:
      Route of transmission
      Example organisms
      Aerosol (airborne particle < 5 µm)
      Mycobacterium tuberculosis
      Varicella zoster virus
      Measles virus

      Hepatitis A and Rotavirus are spread by the faeco-oral route.

      Neisseria gonorrhoea is spread by sexual route.

      Staphylococcus aureus is spread by direct contact.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds

  • Question 25 - A 43-year-old woman presented to the emergency room after an incident of slipping...

    Incorrect

    • A 43-year-old woman presented to the emergency room after an incident of slipping and falling onto her back and left hip. Upon physical examination, it was noted that she has pain on hip abduction, but normal hip extension.

      Which of the following muscles was most likely injured in this case?

      Your Answer:

      Correct Answer: Gluteus medius

      Explanation:

      The primary hip extensors are the gluteus maximus and the hamstrings such as the long head of the biceps femoris, the semitendinosus, and the semimembranosus. The extensor head of the adductor magnus is also considered a primary hip extensor.

      The hip abductor muscle group is located on the lateral thigh. The primary hip abductor muscles include the gluteus medius, gluteus minimus, and tensor fasciae latae.
      The secondary hip abductors include the piriformis, sartorius, and superior fibres of the gluteus maximus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 26 - Intravenous glucose solutions are typically used in the treatment of all of the...

    Incorrect

    • Intravenous glucose solutions are typically used in the treatment of all of the following situations except:

      Your Answer:

      Correct Answer: Hypokalaemia

      Explanation:

      In hypokalaemia, initial potassium replacement therapy should not involve glucose infusions, as glucose may cause a further decrease in the plasma-potassium concentration. Glucose infusions are used for the other indications like diabetic ketoacidosis, hypoglycaemia, routine fluid maintenance in patients who are nil by mouth (very important in children), and in hyperkalaemia.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      0
      Seconds

  • Question 27 - Which of these is NOT a naturally occurring anticoagulant: ...

    Incorrect

    • Which of these is NOT a naturally occurring anticoagulant:

      Your Answer:

      Correct Answer: Factor V Leiden

      Explanation:

      It’s crucial that thrombin’s impact is restricted to the injured site. Tissue factor pathway inhibitor (TFPI), which is produced by endothelial cells and found in plasma and platelets, is the first inhibitor to function. It accumulates near the site of harm induced by local platelet activation. Xa and VIIa, as well as tissue factor, are inhibited by TFPI. Other circulating inhibitors, the most potent of which is antithrombin, can also inactivate thrombin and other protease factors directly. Coagulation cofactors V and VIII are inhibited by protein C and protein S. Tissue plasminogen activator (TPA) from endothelial cells facilitates fibrinolysis by promoting the conversion of plasminogen to plasmin.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 28 - If a patient dislocated his right shoulder and has been referred to the...

    Incorrect

    • If a patient dislocated his right shoulder and has been referred to the orthopaedic outpatient department for a follow-up after a successful reduction, which of the following is the most important position for him to avoid holding his arm in until he is seen in the clinic?

      Your Answer:

      Correct Answer: Arm at 90 degrees to side with palm up

      Explanation:

      The arm should be placed in a poly-sling that should be worn for about two weeks. A physiotherapist may give gentle movements for the arm to help in reducing stiffness and in relieving the pain. It is important that the patient must avoid positions that could cause re-dislocation.
      The most important position to avoid is the arm being held out at 90 degrees to the side with the palm facing upwards, especially if a force is being applied.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 29 - A p value < 0.05 obtained from a study with a significance level...

    Incorrect

    • A p value < 0.05 obtained from a study with a significance level (α) of 0.05, means all of the following, EXCEPT:

      Your Answer:

      Correct Answer: the result is clinically significant.

      Explanation:

      A p value < 0.05:is statistically significantmeans that the probability of obtaining a given result by chance is less than 1 in 20means the null hypothesis is rejectedmeans there is evidence of an association between a variable and an outcomeNote that this does not tell us whether the result is clinically significant.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds

  • Question 30 - Approximately how long is the duration of a lidocaine block (when given with...

    Incorrect

    • Approximately how long is the duration of a lidocaine block (when given with adrenaline):

      Your Answer:

      Correct Answer: 90 minutes

      Explanation:

      Lidocaine is a tertiary amine that is primarily used as a local anaesthetic but can also be used intravenously in the treatment of ventricular dysrhythmias.
      Lidocaine works as a local anaesthetic by diffusing in its uncharged base form through neural sheaths and the axonal membrane to the internal surface of the cell membrane sodium channels. Here it alters signal conduction by blocking the fast voltage-gated sodium channels. 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.
      Each 1 ml of plain 1% lidocaine solution contains 10 mg of lidocaine hydrochloride. The maximum safe dose of plain lidocaine is 3 mg/kg. When administered with adrenaline 1:200,000, the maximum safe dose is 7 mg/kg. Because of the risk of vasoconstriction and tissue necrosis, lidocaine should not be used in combination with adrenaline in extremities such as fingers, toes, and the nose.
      The half-life of lidocaine is 1.5-2 hours. Its onset of action is rapid within a few minutes, and it has a duration of action of 30-60 minutes when used alone. Its duration of action is prolonged by co-administration with adrenaline (about 90 minutes).
      Lidocaine tends to cause vasodilatation when used locally. This is believed to be due mainly to the inhibition of action potentials via sodium channel blocking in vasoconstrictor sympathetic nerves.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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