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  • Question 1 - Which of the following statements regarding the proton pump inhibitors is true? ...

    Incorrect

    • Which of the following statements regarding the proton pump inhibitors is true?

      Your Answer: They reversibly block parietal cell proton pumps

      Correct Answer: They cause hair loss, diarrhoea, and headache

      Explanation:

      Common side effects of omeprazole include: headache, abdominal pain, diarrhoea, nausea, vomiting, gas (flatulence), dizziness, upper respiratory infection, acid reflux, constipation, rash, cough.
      Less common side effects of Omeprazole include: bone fracture (osteoporosis related), deficiency of granulocytes in the blood, loss of appetite, gastric polyps, hip fracture, hair loss, chronic inflammation of the stomach, destruction of skeletal muscle, taste changes, abnormal dreams.
      Rare side effects of Omeprazole include: liver damage, inflammation within the kidneys, pancreatitis, dermatologic disorder, potentially life threatening (toxic epidermal necrolysis).

    • This question is part of the following fields:

      • Pharmacology
      37
      Seconds
  • Question 2 - A 30-year-old female who was on chemotherapy developed a high-grade fever and productive...

    Correct

    • A 30-year-old female who was on chemotherapy developed a high-grade fever and productive cough over 2 days. On examination, there was evidence of a chest infection. Her WBC was 2100/ml. What is the most suitable treatment for this condition?

      Your Answer: Piperacillin+tazobactam

      Explanation:

      This patient has leukopenia following chemotherapy and she is more prone to severe bacterial infections. Neutropenic sepsis is common among cancer patients and it is one of the main reasons for death amongst these patients. As the first line monotherapy for high-risk patients, Piperacillin-tazobactam, Cefepime, Meropenem and Imipenem-cilastatin can be started as they all have antipseudomonal activity.

    • This question is part of the following fields:

      • Haematology & Oncology
      182.1
      Seconds
  • Question 3 - A 48-year-old man is diagnosed with diffuse large B-cell lymphoma and is started...

    Correct

    • A 48-year-old man is diagnosed with diffuse large B-cell lymphoma and is started on chemotherapy. Two days following his first treatment session, he presents to the A&E with nausea, vomiting, and myalgia. On examination, he appears clinically dehydrated. A diagnosis of tumour lysis syndrome (TLS) is suspected.

      Which of the following would be consistent with the diagnosis of TLS?

      Your Answer: Low corrected calcium

      Explanation:

      Out of the aforementioned markers, low corrected calcium is the only biochemistry result consistent with the diagnosis. All of the other markers are elevated in TLS.

      TLS is a potentially fatal condition occurring as a complication during the treatment of high-grade lymphomas and leukaemias. It occurs from the simultaneous breakdown (lysis) of the tumour cells and subsequent release of chemicals into the bloodstream. This leads to hyperkalaemia and hyperphosphatemia in the presence of hyponatraemia. As phosphate precipitates calcium, the serum concentration of calcium becomes low. TLS can occur in the absence of chemotherapy, but it is usually triggered by the introduction of combination chemotherapy. Awareness of the condition is critical for its prophylactic management.

      Patients at high risk of TLS should be given IV rasburicase or IV allopurinol immediately prior to and during the first few days of chemotherapy. Rasburicase is a recombinant version of urate oxidase which is an enzyme that metabolizes uric acid to allantoin. Allantoin is much more water soluble than uric acid and is therefore more easily excreted by the kidneys. Patients in lower-risk groups
      should be given oral allopurinol during cycles of chemotherapy in an attempt to avoid the condition.

      TLS is graded according to the Cairo-Bishop scoring system as:
      1. Laboratory tumour lysis syndrome
      2. Clinical tumour lysis syndrome

    • This question is part of the following fields:

      • Haematology & Oncology
      708.6
      Seconds
  • Question 4 - Which area in the body controls the hypoxic drive to breathe? ...

    Incorrect

    • Which area in the body controls the hypoxic drive to breathe?

      Your Answer: Areas on ventrolateral surface of the medulla

      Correct Answer: Carotid body

      Explanation:

      The carotid body consists of chemosensitive cells at the bifurcation of the common carotid artery that respond to changes in oxygen tension and, to a lesser extent, pH. In contrast to central chemoreceptors (which primarily respond to PaCO2) and the aortic bodies (which primarily have circulatory effects: bradycardia, hypertension, adrenal stimulation, and also bronchoconstriction), carotid bodies are most sensitive to PaO2. At a PaO2 of approximately 55-60 mmHg, they send their impulses via CN IX to the medulla, increasing ventilatory drive (increased respiratory rate, tidal volume, and minute ventilation). Thus, patients who rely on hypoxic respiratory drive will typically have a resting PaO2 around 60 mm Hg.

    • This question is part of the following fields:

      • Respiratory System
      25.6
      Seconds
  • Question 5 - A woman presents with pallor and jaundice. History reveals she has been taking...

    Correct

    • A woman presents with pallor and jaundice. History reveals she has been taking medication to treat her acne. Which of the following medication has she been taking?

      Your Answer: Erythromycin

      Explanation:

      Oral erythromycin is used to treat acne, and has been known to cause various degrees of hepatotoxicity in many patients. It is believed to cause liver lesions leading to hampered bile formation and cholestasis. This presents as jaundice due to the increased movement of bile into the blood instead of into the duodenum. All the other drugs mentioned here are not known to cause such hepatotoxicity.

    • This question is part of the following fields:

      • Hepatobiliary System
      36.3
      Seconds
  • Question 6 - A cohort study is being designed to look at the relationship between smoking...

    Correct

    • A cohort study is being designed to look at the relationship between smoking and prostate cancer. What is the usual outcome measure in a cohort study?

      Your Answer: Relative risk

      Explanation:

      A cohort study is a particular form of longitudinal study that samples a cohort (a group of people who share a defining characteristic, typically those who experienced a common event in a selected period, such as birth or graduation), performing a cross-section at intervals through time.
      The relative risk (RR) or risk ratio is the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group. Relative risk is used in the statistical analysis of the data of experimental, cohort and cross-sectional studies, to estimate the strength of the association between treatments or risk factors, and outcomes.

    • This question is part of the following fields:

      • Evidence Based Medicine
      16.5
      Seconds
  • Question 7 - A 50-year-old female was examined after complaining of weak limbs. It was discovered...

    Incorrect

    • A 50-year-old female was examined after complaining of weak limbs. It was discovered she had burn marks on her fingers, diminished reflexes, and wasted and weak hands. Additionally, she has dissociated sensory loss and weak spastic legs. What is the diagnosis for this patient?

      Your Answer: Freidriech's ataxia

      Correct Answer: Syringomyelia

      Explanation:

      All of the symptoms experienced by this patient are consistent with Syringomyelia. The sensory features are as follows: loss of temperature and pain sensation; sensory loss in the arms, shoulders, and upper body; touch, vibration, and position senses are affected in the feet as the syrinx enlarges into the dorsal column. Motor features are as follows: muscle wasting and weakness which begins in the hand, and moves onto the forearms and shoulders; loss of tendon reflexes. Autonomic involvement, such as the bladder and bowel, can occur.

    • This question is part of the following fields:

      • Nervous System
      64
      Seconds
  • Question 8 - Which of the following statements is false regarding the bioavailability of a drug?...

    Correct

    • Which of the following statements is false regarding the bioavailability of a drug?

      Your Answer: The bioavailability of a drug given orally is often affected by the degree of renal elimination

      Explanation:

      Renal elimination of a drug has no role in altering the bioavailability of a drug.
      The bioavailability of a drug is the proportion of the drug which reaches systemic circulation.
      Mathematically, bioavailability is the AUCoral/AUCiv x 100%, where AUC = area under the concentration-time curve following a single (oral or iv) dose.

      Other options are true:
      By definition, the bioavailability of a drug given intravenously is 100%.
      Drugs given orally that undergo high pre-systemic (first-pass) metabolism in the liver or gut wall have a low bioavailability e.g. lidocaine.
      Bioavailability is also affected by the degree of absorption from the gut and this can change depending on gut motility and administration of other drugs.

    • This question is part of the following fields:

      • Pharmacology
      58.1
      Seconds
  • Question 9 - A 42-year-old man presented with bloody diarrhoea and weight loss. Which one of...

    Incorrect

    • A 42-year-old man presented with bloody diarrhoea and weight loss. Which one of the following would favour the diagnosis of Crohn's disease on rectal biopsy?

      Your Answer: Crypt abscesses

      Correct Answer: Patchy inflammation

      Explanation:

      The correct answer is patchy inflammation. Superficial ulceration as well as non-patchy inflammation are seen in ulcerative colitis (UC) in the colon and rectum; you would expect to see transmural inflammation in Crohn’s disease and it can be patchy and located anywhere from mouth to anus. Crypt distortion and crypt abscesses are seen in both UC and Crohn’s, however they are more common in ulcerative colitis.

    • This question is part of the following fields:

      • Gastrointestinal System
      26.2
      Seconds
  • Question 10 - A 52-year-old hypertensive, smoker presents to ER with right side weakness. He gives...

    Incorrect

    • A 52-year-old hypertensive, smoker presents to ER with right side weakness. He gives a history of multiple falls and lack of concentration. What is the most appropriate diagnosis?

      Your Answer: Lewy body dementia

      Correct Answer: Multi-infarct dementia

      Explanation:

      The patient is a heavy smoker and hypertensive which are risk factors of atherosclerosis and cerebrovascular diseases. The acute onset of the weakness and the lateralization indicates a cerebral infarction.

    • This question is part of the following fields:

      • Nervous System
      16.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pharmacology (1/2) 50%
Haematology & Oncology (2/2) 100%
Respiratory System (0/1) 0%
Hepatobiliary System (1/1) 100%
Evidence Based Medicine (1/1) 100%
Nervous System (0/2) 0%
Gastrointestinal System (0/1) 0%
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