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  • Question 1 - A patient presents with a cough, productive of green sputum and fever. He...

    Incorrect

    • A patient presents with a cough, productive of green sputum and fever. He was commenced on antibiotics 4 days earlier, but his condition has worsened. There is a documented history of penicillin allergy, and the GP prescribed erythromycin.

      Erythromycin exert its pharmacological effect by binding to?

      Your Answer: The 30S subunit of the bacterial ribosome

      Correct Answer: The 50S subunit of the bacterial ribosome

      Explanation:

      Macrolides are bacteriostatic antibiotics. They act by binding to the 50S subunit of the bacterial ribosome and inhibit translocation, therefore, inhibiting protein synthesis.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      29.4
      Seconds
  • Question 2 - An analytical cohort study is done to compare the relationship between omega 3...

    Correct

    • An analytical cohort study is done to compare the relationship between omega 3 intake and occurrence of myocardial infarction (MI) among males aged over 65 years. The following are the data from the study:

      No. of subjects taking placebo: 100 men
      No. of subjects taking placebo who suffered an MI: 15 men

      No. of subjects taking omega 3: 100 men
      No. of subjects taking omega 3 who suffered an MI: 5 men

      Compute for the relative risk of the study.

      Your Answer: 0.33

      Explanation:

      Relative risk (RR) is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.

      RR can be computed as the absolute risk of events in the treatment group (ART), divided by the absolute risk of events in the control group (ARC).

      RR = ART/ARC
      RR = (5/100) / (15/100)
      RR = 0.33

    • This question is part of the following fields:

      • Evidence Based Medicine
      15.6
      Seconds
  • Question 3 - A 29 year old patient with known inflammatory bowel disease presents to ED...

    Incorrect

    • A 29 year old patient with known inflammatory bowel disease presents to ED with surgical complications following his recent ileocaecal resection. Removal of the terminal ileum may result in the malabsorption of which of the following:

      Your Answer: Iron

      Correct Answer: Vitamin B12

      Explanation:

      On ingestion, vitamin B12 is bound to R protein found in saliva and gastric secretions, which protects it from digestion in the stomach. Intrinsic factor is secreted by gastric parietal cells. Receptors for the IF-B12 complex are present in the membrane of epithelial cells of the terminal ileum, which bind the complex and allow uptake of vitamin B12 across the apical membrane by endocytosis. Vitamin B12 is then transported across the basal membrane into the portal blood where it is bound to transcobalamin II and processed by the liver. In pernicious anaemia, there are autoantibodies against gastric parietal cells and intrinsic factor, resulting in vitamin B12 deficiency anaemia.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      32.2
      Seconds
  • Question 4 - Fracture of the medial epicondyle would result to the following, except ...

    Correct

    • Fracture of the medial epicondyle would result to the following, except

      Your Answer: Weakness of abduction of the thumb

      Explanation:

      Thumb abduction is mediated by the abductor pollicis longus and brevis, which are innervated by the radial and median nerves, respectively.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      1039.6
      Seconds
  • Question 5 - A 52-year-old female visits the Emergency Department complaining of an acute worsening of...

    Incorrect

    • A 52-year-old female visits the Emergency Department complaining of an acute worsening of her asthma symptoms. A detailed history reveals that she took one of her brother's heart pills without a prescription as she was experiencing palpitations and thought it would cure her. Her shortness of breath was suddenly exacerbated after ingesting this medicine.

      Which one of the following medications has this woman most likely consumed?

      Your Answer: Ramipril

      Correct Answer: Propranolol

      Explanation:

      Propranolol, like other non-selective beta-blockers, is contraindicated in patients with asthma. These drugs can cause acute bronchospasm, therefore worsening symptoms, especially in high doses. However, there has been some recent evidence that long-term use of selective beta-blockers in mild or moderate asthma patients can be safe.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      24
      Seconds
  • Question 6 - Which of the following laboratory findings is NOT typical of von Willebrand disease...

    Incorrect

    • Which of the following laboratory findings is NOT typical of von Willebrand disease (VWD):

      Your Answer: Abnormal PFA-100

      Correct Answer: Thrombocytopaenia

      Explanation:

      Laboratory findings typically show (although this varies depending on VWD type):
      Abnormal PFA-100 test
      Low factor VIII levels (if low a factor VIII/VWF binding assay is performed)
      Prolonged APTT (or normal)
      Normal PT
      Low VWF levels
      Defective platelet aggregation
      Normal platelet count

    • This question is part of the following fields:

      • Haematology
      • Pathology
      15.2
      Seconds
  • Question 7 - An increased anion gap metabolic acidosis is typically caused by which of the...

    Incorrect

    • An increased anion gap metabolic acidosis is typically caused by which of the following?

      Your Answer: Chronic diarrhoea

      Correct Answer: Propylene glycol overdose

      Explanation:

      Causes of a raised anion gap acidosis can be remember using the mnemonic MUDPILES:
      -Methanol
      -Uraemia (in renal failure)
      -Diabetic ketoacidosis
      -Propylene glycol overdose
      -Infection/Iron overdose/Isoniazid/Inborn errors of metabolism
      -Lactic acidosis
      -Ethylene glycol overdose
      -Salicylate overdose

    • This question is part of the following fields:

      • Physiology
      • Renal
      16.7
      Seconds
  • Question 8 - A 6-year-old girl is brought into the paediatric emergency room by her mother...

    Incorrect

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

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

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

      Your Answer: Ciprofloxacin

      Correct Answer: Trimethoprim

      Explanation:

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

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

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      10.1
      Seconds
  • Question 9 - A patient suffers a lower limb fracture that causes damage to the nerve...

    Incorrect

    • A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus longus.
      Peroneus longus receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer:

      Correct Answer: Superficial peroneal nerve

      Explanation:

      Peroneus brevis is innervated by the superficial peroneal nerve.
      Peroneus longus is innervated by the superficial peroneal nerve.
      Peroneus tertius is innervated by the deep peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 10 - Noradrenaline exhibits its positive inotropic effect by which of the following mechanisms: ...

    Incorrect

    • Noradrenaline exhibits its positive inotropic effect by which of the following mechanisms:

      Your Answer:

      Correct Answer: Binds to beta1-receptors and causes increased Ca2+ entry via L-type channels during the action potential

      Explanation:

      Noradrenaline (the sympathetic neurotransmitter) is a positive inotrope; it binds to β1-adrenoceptors on the membrane and causes increased Ca2+entry via L-type channels during the AP and thus increases Ca2+release from the SR. Noradrenaline also increases Ca2+sequestration into the SR and thus more Ca2+is available for the next contraction. Cardiac glycosides (e.g. digoxin) slow the removal of Ca2+from the cell by inhibiting the membrane Na+pump which generates the Na+gradient required for driving the export of Ca2+; consequently the removal of Ca2+from the myocyte is slowed and more Ca2+is available for the next contraction. Acidosis is negatively inotropic, largely because H+competes for Ca2+binding sites.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 11 - You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble...

    Incorrect

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

      Your Answer:

      Correct Answer: Mast cell tryptase

      Explanation:

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

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

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

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      0
      Seconds
  • Question 12 - A 67-year-old woman arrives at the Emergency Department with chest pain. Flecainide is...

    Incorrect

    • A 67-year-old woman arrives at the Emergency Department with chest pain. Flecainide is one of the medications she is taking.

      Which of the following statements about flecainide mechanism of action is correct?

      Your Answer:

      Correct Answer: Blocks Na+ channels in the heart

      Explanation:

      Flecainide is an antiarrhythmic drug of class Ic that works by blocking the Nav1.5 sodium channel in the heart, prolonging the cardiac action potential and slowing cardiac impulse conduction. It has a significant impact on accessory pathway conduction, particularly retrograde conduction, and significantly reduces ventricular ectopic foci.

      Many different arrhythmias can be treated with flecainide, including:
      Pre-excitation syndromes (e.g. Wolff-Parkinson-White)
      Acute atrial arrhythmias
      Ventricular arrhythmias
      Chronic neuropathic pain

      The use of flecainide is contraindicated in the following situations:
      Abnormal left ventricular function
      Atrial conduction defects (unless pacing rescue available)
      Bundle branch block (unless pacing rescue available)
      Distal block (unless pacing rescue available)
      Haemodynamically significant valvular heart disease
      Heart failure
      History of myocardial infarction
      Long-standing atrial fibrillation where conversion to sinus rhythm not attempted
      Second-degree or greater AV block (unless pacing rescue available)
      Sinus node dysfunction (unless pacing rescue available)

      Flecainide should only be used in people who don’t have a structural heart problem. The CAST trial found a significant increase in sudden cardiac death and all-cause mortality in patients with an ejection fraction of less than 40% after a myocardial infarction, where it tended to be pro-arrhythmic.

      Anti-arrhythmic drugs have a limited and ineffective role in the treatment of atrial flutter. It’s important to keep in mind that flecainide shouldn’t be used by itself to treat atrial flutter. When used alone, there is a risk of inducing 1:1 atrioventricular conduction, which results in an increase in ventricular rate that is paradoxical. As a result, it should be used in conjunction with a beta-blocker or a calcium channel blocker with a rate-limiting effect.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 13 - Which of the following statements is true regarding a pleural aspiration? ...

    Incorrect

    • Which of the following statements is true regarding a pleural aspiration?

      Your Answer:

      Correct Answer: The needle should be inserted just above the upper border of the chosen rib

      Explanation:

      Pleural aspiration describes a procedure whereby pleural fluid or air may be aspirated via a system inserted temporarily into the pleural space. This may be for diagnostic purposes (usually removing 20–50 ml fluid) or therapeutic to relieve symptoms. In the literature it is varyingly called thoracocentesis, thoracentesis or pleural aspiration.

      In determining the correct patient position and site of insertion, it is important for the operator to be aware of the normal anatomy of the thorax and the pathology of the patient. Patient position is dependent on the operator preference and the site of the pathology. In the case of a posterior lying locule, this may be specific to the image-guided spot where fluid is most likely to be obtained. In most circumstances, however, the site of insertion of the needle is either in the triangle of safety or the second intercostal space in the midclavicular line. The patient may therefore either sit upright leaning forward with arms elevated but resting on a table or bed, thereby exposing the axilla, or lying on a bed in a position. The needle is inserted in the space just above the chosen rib to avoid damaging the neurovascular bundle. It is common practice to insert the needle more posteriorly for a pleural aspiration, but it should be noted that the neurovascular bundle may not be covered by the lower flange of the rib in this position and a more lateral or anterior site of insertion is considered safer.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 14 - 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:

      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
      0
      Seconds
  • Question 15 - Which of the following organisms can penetrate intact skin: ...

    Incorrect

    • Which of the following organisms can penetrate intact skin:

      Your Answer:

      Correct Answer: Leptospira spp.

      Explanation:

      Leptospirosis is a bacterial disease caused byLeptospira spp. It is the most common zoonotic infection worldwide.
      It is usually contracted by exposure to water contaminated with the urine of infected animals (such as rodents, cattle, and dogs). The most important reservoirs are rodents, and rats are the most common source worldwide.
      The bacteria enter the body through the skin or mucous membranes. This is more likely if the skin is broken by leptospirosis is somewhat unusual in that it can enter the body through intact skin.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      0
      Seconds
  • Question 16 - What is the maximum strength of a scar versus unwounded skin: ...

    Incorrect

    • What is the maximum strength of a scar versus unwounded skin:

      Your Answer:

      Correct Answer: 0.8

      Explanation:

      Basic healing is complete by 5-10 days but maximal wound strength (80% of normal) may take 12 weeks.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      0
      Seconds
  • Question 17 - You examine a 78-year-old man who has been diagnosed with chronic lymphocytic leukaemia...

    Incorrect

    • You examine a 78-year-old man who has been diagnosed with chronic lymphocytic leukaemia (CLL).

      What is the MAIN contributory factor in this condition's immunodeficiency?

      Your Answer:

      Correct Answer: Hypogammaglobulinemia

      Explanation:

      Immunodeficiency is present in all patients with chronic lymphocytic leukaemia (CLL), though it is often mild and not clinically significant. Infections are the leading cause of death in 25-50 percent of CLL patients, with respiratory tract, skin, and urinary tract infections being the most common.

      Hypogammaglobulinemia is the most common cause of immunodeficiency in CLL patients, accounting for about 85 percent of all cases.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 18 - A 20-year-old male patient lives in a travelling community and has never...

    Incorrect

    • A 20-year-old male patient lives in a travelling community and has never received any vaccinations. He presents to you with fever.

      Which of these statements concerning indications and contraindications for vaccination is FALSE?

      Your Answer:

      Correct Answer: Premature infants should have the their immunisation schedule adjusted for gestational age

      Explanation:

      All vaccines are contraindicated in individuals with:
      A confirmed anaphylactic reaction to a previous dose of the vaccine or a vaccine containing the same antigens.
      A confirmed anaphylactic reaction to a component in the vaccine e.g. neomycin

      Live attenuated vaccines are contraindicated in pregnancy except in cases where risk of infection is more than the risks of vaccination.

      During times of acute febrile illness, vaccination should be avoided.

      12 weeks should elapse after a dose of human immunoglobulin before a live vaccine is administered.

      The normal times recommended for immunization of full-term babies should also be applied to premature infants and correction for gestational age should NOT be implemented.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds
  • Question 19 - All of the following statements are considered true regarding likelihood ratios, except: ...

    Incorrect

    • All of the following statements are considered true regarding likelihood ratios, except:

      Your Answer:

      Correct Answer: If less than one, indicates that the information increases the likelihood of the suspected diagnosis

      Explanation:

      The Likelihood Ratio (LR) is the likelihood that a given test result would be expected in a patient with the target disorder compared to the likelihood that that same result would be expected in a patient without the target disorder.

      The LR is used to assess how good a diagnostic test is and to help in selecting an appropriate diagnostic tests or sequence of tests. They have advantages over sensitivity and specificity because they are less likely to change with the prevalence of the disorder, they can be calculated for several levels of the symptom/sign or test, they can be used to combine the results of multiple diagnostic test and they can be used to calculate post-test probability for a target disorder.

      A LR greater than 1 produces a post-test probability which is higher than the pre-test probability. An LR less than 1 produces a post-test probability which is lower than the pre-test probability. When the pre-test probability lies between 30 and 70 per cent, test results with a very high LR (say, above 10) rule in disease. An LR below 1 produces a post-test probability les than the pre-test probability. A very low LR (say, below 0.1) virtually rules out the chance that the patient has the disease.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds
  • Question 20 - A 66-year-old male is brought to your clinic by his wife with the...

    Incorrect

    • A 66-year-old male is brought to your clinic by his wife with the complaint of increasing confusion and disorientation over the past three days, along with decreased urination. She reports that he has been complaining of increasing pain in his back and ribs over the past three months.

      On examination, the patient looks anaemic, is not oriented in time, place and person and has tenderness on palpation of the lumbar spine and the 10th, 11th and 12th ribs.

      Blood tests show anaemia which is normocytic, normochromic, raised urea and creatinine and hypercalcemia.

      Which one of the following diagnoses is most likely in this case?

      Your Answer:

      Correct Answer: Multiple myeloma

      Explanation:

      Multiple myeloma is a clonal abnormality affecting plasma cells in which there is an overproduction of functionless immunoglobulins. The most common patient complaint is bone pain, especially in the back and ribs. Anaemia and renal failure are common, along with hypercalcemia. Hypercalcemia may lead to an altered mental status, as in this case.

      Chronic lymphocytic leukaemia occurs due to the overproduction of lymphocytes, usually B cells. CLL may present with an asymptomatic elevation of B cells. Patients are generally more than 50 years old and present with non-specific fatigue and weight loss symptoms.

      There is no history of alcohol abuse in this case. Furthermore, patients with a history of alcohol abuse may have signs of liver failure, which are not present here.

      Metastatic prostate cancer would most often cause lower backache as it metastasises first to the lumbar spine via the vertebral venous plexus.

      A patient with Vitamin B12 deficiency would have anaemia, megaloblastic, hypersegmented neutrophils, and signs of peripheral neuropathy.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 21 - Which of the following is NOT an advantage of a case-control study used...

    Incorrect

    • Which of the following is NOT an advantage of a case-control study used to identify past exposure to a risk factor in patients with a disease:

      Your Answer:

      Correct Answer: Can directly measure absolute and relative risk of a disease

      Explanation:

      Advantages:relatively quickrelatively cheap and easy to performparticularly suitable for studying associations between an exposure and an outcome when the outcome is uncommon or if the outcome occurs decades after exposurea wide range of risk factors can be investigated in each studyDisadvantages:subject to recall biasunlike in a whole population study, absolute risk cannot be quantifiedtemporal relationship between exposure and outcome can be difficult to establishunsuitable for rare risk factorsprone to confounding

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      0
      Seconds
  • Question 22 - Which of the following cell types in the stomach secretes histamine? ...

    Incorrect

    • Which of the following cell types in the stomach secretes histamine?

      Your Answer:

      Correct Answer: Enterochromaffin-like cells

      Explanation:

      The parietal cells operate in close association with another type of cell called enterochromaffin-like cells (ECL cells), the primary function of which is to secrete histamine. The ECL cells lie in the deep recesses of the oxyntic glands and therefore release histamine indirect contact with the parietal cells of the glands.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds
  • Question 23 - Which of the following best describes the main sites of constriction of the...

    Incorrect

    • Which of the following best describes the main sites of constriction of the ureters:

      Your Answer:

      Correct Answer: At the ureteropelvic junction, at the pelvic brim and where the ureters enter the bladder

      Explanation:

      At three points along their course, the ureters are constricted denoting the most likely areas for renal calculi to lodge:the first point is at the ureteropelvic junction (where the renal pelvis becomes continuous with the ureter)the second point is where the ureter crosses the common iliac vessels at the pelvic brimthe third point is at the vesicoureteric junction (where the ureter enters the wall of the bladder)

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 24 - All of the following single clinical risk groups is considered eligible to receive...

    Incorrect

    • All of the following single clinical risk groups is considered eligible to receive the seasonal influenza vaccination, except:

      Your Answer:

      Correct Answer: Patients with hypertension

      Explanation:

      The following is the list of all the health and age factors that are known to increase a person’s risk of getting serious complications from flu:
      – Adults 65 years and older
      – Children younger than 2 years old
      – Asthma
      – Neurological and neurodevelopmental conditions
      – Blood disorders (such as sickle cell disease)
      – Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
      – Endocrine disorders (such as diabetes mellitus)
      – Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
      – Kidney diseases
      – Liver disorders
      – Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
      – People who are obese with a body mass index [BMI] of 40 or higher
      – People younger than 19 years old on long-term aspirin- or salicylate-containing medications.
      – People with a weakened immune system due to disease (such as people with HIV or AIDS, or some cancers such as leukaemia) or medications (such as those receiving chemotherapy or radiation treatment for cancer, or persons with chronic conditions requiring chronic corticosteroids or other drugs that suppress the immune system)
      – People who have had a stroke
      – Pregnant people and people up to 2 weeks after the end of pregnancy
      – People who live in nursing homes and other long-term care facilities

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
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  • Question 25 - The Meissner’s plexus acts as the main control for gastrointestinal secretion and local...

    Incorrect

    • The Meissner’s plexus acts as the main control for gastrointestinal secretion and local blood flow within the gut.

      The Meissner’s plexus lies in which layer of the gut wall?

      Your Answer:

      Correct Answer: Submucosa

      Explanation:

      The Meissner’s plexus (submucosal plexus), an enteric nervous plexus, acts as the main control for gastrointestinal secretion and local blood flow within the gut.

      It is located in the submucosal layer on the inner surface of the muscularis externa.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      0
      Seconds
  • Question 26 - You suspect that your patient with polycystic kidney disease has developed a berry...

    Incorrect

    • You suspect that your patient with polycystic kidney disease has developed a berry aneurysm as a complication of his disease. The patient complains of a sudden, severe headache. You are guessing subarachnoid haemorrhage secondary to a ruptured berry aneurysm as the cause of his severe headaches. What is the most likely location of his aneurysm?

      Your Answer:

      Correct Answer: Anterior communicating artery

      Explanation:

      One of the complications that polycystic kidney disease may cause is the development of a brain aneurysm.

      A berry aneurysm is the most common type of brain aneurysm.

      The Circle of Willis, where the major blood vessels meet at the base of the brain, is where it usually appears. The most common junctions of the Circle of Willis where an aneurysm may occur include the anterior communicating artery (35%), internal carotid artery (30%), the posterior communicating artery and the middle cerebral artery (22%), and finally, the posterior circulation sites, most commonly the basilar artery tip.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 27 - While on morning rounds in the medical ward, the attending physician asks a...

    Incorrect

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

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

      Your Answer:

      Correct Answer: Meig’s syndrome

      Explanation:

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

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

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 28 - A novel anti-tuberculosis medicine was compared to standard treatment and shown to cut...

    Incorrect

    • A novel anti-tuberculosis medicine was compared to standard treatment and shown to cut the risk of death from 30 to 10 per 1000 people. How many patients would need to be treated (number need to treat (NNT)) in order to prevent 10 additional tuberculosis deaths:

      Your Answer:

      Correct Answer: 500

      Explanation:

      The risk of mortality in the control group (usual therapy) minus the risk of death in the treatment group equals the absolute risk reduction (ARR) of treatment.
      30/1000 minus 10/1000 = 20/1000 = 0.02

      NNT = 1/ARR = 1/0.02 = 50
      As a result, 50 people would need to be treated in order to prevent one additional fatality, and 500 people would need to be treated in order to avoid 10 additional deaths.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds
  • Question 29 - Regarding ciprofloxacin, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Ciprofloxacin decreases plasma concentrations of theophylline.

      Explanation:

      Ciprofloxacin increases plasma concentrations of theophylline. There is an increased risk of convulsions when quinolones are given with NSAIDs or theophylline. There is an increased risk of tendon damage when quinolones are given with corticosteroids. Quinolones are known to increase the QT-interval and should not be taken with concomitantly with other drugs that are known to cause QT-interval prolongation. There is an increased risk of myopathy when erythromycin or clarithromycin are taken with simvastatin or atorvastatin.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 30 - About case-control studies, one of the following is true. ...

    Incorrect

    • About case-control studies, one of the following is true.

      Your Answer:

      Correct Answer: They are suitable to be used in the study of rare diseases

      Explanation:

      Case-control studies are suitable when investigating a rare disease or in cases where little is known about the disease and the proposed aetiological factor, as a preliminary study. They have the ability to look at multiple risk-factors (exposures) but can only look at a single outcome.

      In a case-control study, two groups of patients, one with the disease and one without, are compared on the basis of a proposed causative factor that occurred in the past. They are therefore a retrospective study and useful in hypothesis generation.

      Cohort studies are better at identifying rare exposures. One group with an exposure is compared to a control group without that exposure.

      Case-control studies are usually less expensive to run and also shorter in duration compared with prospective cohort studies.

    • This question is part of the following fields:

      • Evidence Based Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY

Infections (0/2) 0%
Pharmacology (0/3) 0%
Evidence Based Medicine (1/1) 100%
Gastrointestinal (0/1) 0%
Physiology (0/2) 0%
Anatomy (1/1) 100%
Upper Limb (1/1) 100%
Cardiovascular Pharmacology (0/1) 0%
Haematology (0/1) 0%
Pathology (0/1) 0%
Renal (0/1) 0%
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