00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - A 24-year-old male presents to the Emergency Department with a three-day history of...

    Incorrect

    • A 24-year-old male presents to the Emergency Department with a three-day history of high-grade fever, headache and rash along with neck stiffness. On examination, Kernig's sign is positive, and you note a petechial rash over the trunk and limbs. Her vital signs show tachycardia and hypotension. Based on these findings, you diagnose sepsis secondary to meningitis.

      Which one of the following definitions of sepsis is currently accepted?

      Your Answer: Severe infection in the presence of tissue hypoperfusion persisting an hour after resuscitation with intravenous fluids

      Correct Answer: Life-threatening organ dysfunction caused by a dysregulated host response to infection

      Explanation:

      In 2016 the SOFA guideline was introduced, also called the Sepsis-related Organ Failure Assessment, to make a sepsis diagnosis easier and prevent mortality.

      According to this guideline, sepsis was defined as a life-threatening organ dysfunction due to a dysregulated host response to infection.

      Septic shock was defined as a subset of sepsis in which the circulatory and metabolic abnormalities would lead to a greater risk of mortality than sepsis alone. Patients with septic shock would be clinically identified by a need for vasopressors to maintain MAP greater than 65 mmHg and serum lactate greater than two mmol/L.

    • This question is part of the following fields:

      • Pathology
      • Pathology Of Infections
      53
      Seconds
  • Question 2 - Glucagon is the main catabolic hormone of the body and raises the concentration...

    Correct

    • Glucagon is the main catabolic hormone of the body and raises the concentration of glucose and fat in the bloodstream.

      Which pancreatic islet cells secretes glucagon?

      Your Answer: Alpha

      Explanation:

      Glucagon, secreted from the pancreatic islet alpha cells, is considered to be the main catabolic hormone of the body. It raises the concentration of glucose and fat in the bloodstream

      There are five different pancreatic islet cells:
      Alpha cells (20%) – produce glucagon
      Beta cells (70%) – produce insulin and amylin
      Delta cells (<10%) – produce somatostatin
      Gamma cells (<5%) – produce pancreatic polypeptide
      Epsilon cells (<1%) – produce ghrelin

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      22.5
      Seconds
  • Question 3 - Regarding antacids, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Antacids are best taken regularly each morning for maximum symptom control.

      Correct Answer: Antacids are contraindicated in hypophosphataemia.

      Explanation:

      Antacids are contraindicated in hypophosphataemia. Liquid preparations are more effective than tablet preparations. Magnesium-containing antacids tend to be laxative whereas aluminium-containing antacids tend to be constipating. Antacids are best taken when symptoms occur or are expected, usually between meals and at bedtime. Antacids should preferably not be taken at the same time as other drugs since they may impair absorption.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      23.8
      Seconds
  • Question 4 - You see a 30-year-old man who has come to the department with a...

    Incorrect

    • You see a 30-year-old man who has come to the department with a very tender right elbow. On examination, the elbow is very hot and red, and appears to be acutely inflamed.
      Which SINGLE statement regarding acute inflammation is FALSE?

      Your Answer: Vasoactive mediators, such as nitric oxide and histamine increase capillary permeability

      Correct Answer: Reduced extravascular osmotic pressure leads to oedema

      Explanation:

      Inflammation can be divided intoacute inflammation, which occurs over seconds, minutes, hours, and days, andchronic inflammation, which occurs over longer periods.
      Acute inflammationcommences within seconds or minutes following the injury of tissues. There are numerous potential stimuli for an acute inflammatory response including infections (bacterial, viral, fungal, parasitic), tissue necrosis, foreign bodies, and Immune reactions (hypersensitivity reactions). The chief cell type of acute inflammation is the neutrophil.
      There are three main processesthat occur in the acute inflammatory response:
      Increased blood flow
      Increased capillary permeability
      Neutrophil migration
      1. Increased blood flow:
      Vasoactive mediators are released, such as nitric oxide, histamine, bradykinins, and prostaglandin E2. These mediators cause vasodilatation and increased blood flow to the area (causing redness and heat).
      2. Increased capillary permeability:
      The vasoactive mediators also cause increased capillary permeability by causing endothelial cell contraction that widens the intercellular gaps of venules. This allows an outpouring of protein-rich fluid (exudate) into the extracellular tissues that results in a reduction of intravascular osmotic pressure and an increase in extravascular/interstitial pressure. The increased interstitial osmotic pressure leads to oedema.
      3. Neutrophil migration:
      Neutrophils leave the vasculature through the following sequence of events:
      Margination and rolling: neutrophils flow nearer the vessel wall, rather than in the axial stream, which is referred to as margination. Following margination the neutrophils begin rolling along the surface of the vascular endothelium.
      Activation and adhesion: then as a result of interaction with endothelial cell adhesion molecules (CAMs) that is mediated by selectins, the neutrophils are activated and adhere to the endothelium.
      Transmigration: once bound to the endothelium, neutrophils squeeze through gaps between adjacent endothelial cells into the interstitial fluid, in a process calleddiapedesis.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      58.2
      Seconds
  • Question 5 - A patient presents with severe vomiting. They take a maintenance dose of 12.5...

    Incorrect

    • A patient presents with severe vomiting. They take a maintenance dose of 12.5 mg of prednisolone daily for their COPD. They are unable to swallow or keep down tablets at present, and you plan on converting them to IV hydrocortisone.
      What dose of hydrocortisone is equivalent to this dose of prednisolone? Select ONE answer only.

      Your Answer: 100 mg

      Correct Answer: 50 mg

      Explanation:

      Prednisolone is four times more potent than hydrocortisone, and therefore, a dose of 12.5 mg would be equivalent to 50 mg of hydrocortisone.
      The following table summarises the relative potency of the main corticosteroids compared with hydrocortisone:
      Corticosteroid
      Potency relative to hydrocortisone
      Prednisolone
      4 times more potent
      Triamcinolone
      5 times more potent
      Methylprednisolone
      5 times more potent
      Dexamethasone
      25 times more potent

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      68.2
      Seconds
  • Question 6 - Regarding thalassaemia, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Alpha-thalassaemia is more common in the Mediterranean region.

      Correct Answer: Screening for thalassaemia in pregnancy is offered to all pregnant women.

      Explanation:

      Beta thalassemia is caused by mutations in one or both of the beta globin genes. Alpha thalassemia is caused by a deletion or mutation (less commonly) in one or more of the four alpha globin gene copies. β-thalassaemia is more common in the Mediterranean region while α-thalassaemia is more common in the Far East.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      52.8
      Seconds
  • Question 7 - A 32-year-old woman with a history of bipolar disorder exhibits lithium toxicity symptoms.

    Which...

    Incorrect

    • A 32-year-old woman with a history of bipolar disorder exhibits lithium toxicity symptoms.

      Which of the following is the MOST LIKELY feature to be present?

      Your Answer: Syndrome of inappropriate antidiuresis

      Correct Answer: Clonus

      Explanation:

      Lithium toxicity manifests itself in the following ways:
      Ataxia
      Clonus
      Coma
      Confusion
      Convulsions
      Diarrhoea
      Increased muscle tone
      Nausea and vomiting
      Nephrogenic diabetes insipidus
      Renal failure
      Tremor

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      53.6
      Seconds
  • Question 8 - Which of the following microbes adheres to the genital mucosa using fimbriae: ...

    Incorrect

    • Which of the following microbes adheres to the genital mucosa using fimbriae:

      Your Answer: Treponema pallidum

      Correct Answer: Neisseria gonorrhoeae

      Explanation:

      Infection of the genital mucosa by Neisseria gonorrhoeae involves attachment to and invasion of epithelial cells. Initial adherence of gonococci to columnar epithelial cells is mediated by type IV pili assembled from pilin subunit PilE proteins and pilus tip-associated PilC proteins, it then invades the epithelial layer, triggering a local acute inflammatory response.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      36.5
      Seconds
  • Question 9 - A 68-year-old female has presented to the Emergency Department with chest pain, palpitations,...

    Correct

    • A 68-year-old female has presented to the Emergency Department with chest pain, palpitations, and breathlessness complaints. On ECG, she is diagnosed with ventricular arrhythmia and is administered lidocaine.

      Which of the following is the correct mechanism of action of lidocaine?

      Your Answer: Blocks Na+ channels in the heart

      Explanation:

      Lidocaine is a tertiary amide local anaesthetic and also a class IV antiarrhythmic.

      Like other local anaesthetics, lidocaine works on the voltage-gated sodium ion channel on the nerve cell membranes. It works in the following steps:
      1. diffuses through neural sheaths and the axonal membrane into the axoplasm
      2. binds fast voltage-gated Na+ channels in the neuronal cell membrane and inactivates them
      3. 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

      The same principle applies to Lidocaine’s actions in the heart as it blocks the sodium channels in the conduction system and the myocardium. This raises the threshold for depolarizing, making it less likely for the heart to initiate or conduct any action potential that can cause arrhythmia.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      19.8
      Seconds
  • Question 10 - A 5-year-old girl presents in a paediatric clinic with symptoms of viral gastroenteritis....

    Incorrect

    • A 5-year-old girl presents in a paediatric clinic with symptoms of viral gastroenteritis. You encourage the mother to treat the child at home with oral rehydration therapy (ORT), e.g. dioralyte.

      Out of the following, which statement is FALSE regarding the use of ORT in the management of gastroenteritis?

      Your Answer: ORT contains salts

      Correct Answer: ORT is sugar-free

      Explanation:

      One of the major complications of gastroenteritis is dehydration. Choosing the correct fluid replacement therapy is essential according to a patient’s hydration status.

      Oral rehydration therapy (ORT) refers to the restitution of water and electrolyte deficits in dehydrated patients using an oral rehydration salt (ORS) solution. It is a fluid replacement strategy that is less invasive than other strategies for fluid replacement and has successfully lowered the mortality rate of diarrhoea in developing countries.

      Some characteristics of Oral rehydration solutions are:
      – slightly hypo-osmolar (about 250 mmol/litre) to prevent the possible induction of osmotic diarrhoea.
      – contain glucose (e.g. 90 mmol/L in dioralyte). The addition of glucose improves sodium and water absorption in the bowel and prevents hypoglycaemia.
      – also contains essential mineral salts

      Current NICE guidance recommends that 50 ml/kg is given over 4 hours to treat mild dehydration.
      Once rehydrated, a child should continue with their usual daily fluid intake plus 200 ml ORT after each loose stool. In an infant, give ORT at 1-1.5 x the normal feed volume and in an adult, give 200-400 ml after each loose stool.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pharmacology
      64.7
      Seconds
  • Question 11 - An unrelated medical condition brings a 28-year-old asthmatic man to the Emergency Department....

    Incorrect

    • An unrelated medical condition brings a 28-year-old asthmatic man to the Emergency Department. When you look over his meds, you notice that he is taking Theophylline to help with his asthma.

      Which of the following medicines should you NOT prescribe?

      Your Answer: Amitriptyline

      Correct Answer: Ciprofloxacin

      Explanation:

      Ciprofloxacin is a cytochrome P450 enzyme inhibitor that raises theophylline levels in the blood. As a result, co-prescribing theophylline should be avoided.

      The medicines that typically impact theophylline’s half-life and plasma concentration are listed in the table below:
      Drugs that increase the levels of theophylline in the blood
      Drugs that lower theophylline levels in the blood
      Calcium channel blockers e.g. Verapamil
      Fluconazole
      Cimetidine
      Quinolones, e.g. ciprofloxacin
      Methotrexate
      Barbiturates
      Carbamazepine
      Phenobarbital
      Macrolides, e.g. erythromycin
      Phenytoin (and fosphenytoin)
      Rifampicin
      St. John’s wort

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      45.6
      Seconds
  • Question 12 - What is the primary route of transmission of Neisseria Gonorrhoeae? ...

    Correct

    • What is the primary route of transmission of Neisseria Gonorrhoeae?

      Your Answer: Sexually transmitted

      Explanation:

      Neisseria gonorrhoeae is primarily spread by sexual contact or through transmission during childbirth. It causes gonorrhoea which is a purulent infection of the mucous membrane surfaces.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      16
      Seconds
  • Question 13 - The following are all important buffers of H+EXCEPT for: ...

    Correct

    • The following are all important buffers of H+EXCEPT for:

      Your Answer: Calcium

      Explanation:

      Buffers are weak acids or bases that can donate or accept H+ions respectively and therefore resist changes in pH. Buffering does not alter the body’s overall H+load, ultimately the body must get rid of H+by renal excretion if the buffering capacity of the body is not to be exceeded and a dangerous pH reached. Bicarbonate and carbonic acid (formed by the combination of CO2 with water, potentiated by carbonic anhydrase) are the most important buffer pair in the body, although haemoglobin provides about 20% of buffering in the blood, and phosphate and proteins provide intracellular buffering. Buffers in urine, largely phosphate, allow the excretion of large quantities of H+.

    • This question is part of the following fields:

      • Physiology
      • Renal
      39.4
      Seconds
  • Question 14 - Regarding cytotoxic T cells, which of the following statements is CORRECT: ...

    Correct

    • Regarding cytotoxic T cells, which of the following statements is CORRECT:

      Your Answer: They kill target cells by inducing cell apoptosis.

      Explanation:

      CD8+ T-cells (Cytotoxic T cells)
      Recognise antigen only in association with HLA Class I molecules (found on all nucleated cells; present endogenous antigens such as those found in cells infected by viruses or intracellular bacteria.)
      Comprise about 25% of peripheral T-cells
      Responsible for cytotoxic killing of target cells

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      15
      Seconds
  • Question 15 - Which of the following nerves supplies the abductor pollicis brevis? ...

    Correct

    • Which of the following nerves supplies the abductor pollicis brevis?

      Your Answer: The recurrent branch of the median nerve

      Explanation:

      Abductor pollicis brevis is innervated by the recurrent (thenar) branch of median nerve (root value C8 and T1).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      70.1
      Seconds
  • Question 16 - A 32 year old man is brought to ED having been thrown off...

    Correct

    • A 32 year old man is brought to ED having been thrown off his motorbike. Following initial resuscitation and ruling out life-threatening injuries, you establish the patient has weakness of hip flexion. Which of the following nerves has most likely been injured:

      Your Answer: Femoral nerve

      Explanation:

      Flexion of the hip is produced by the iliacus, the psoas major, the sartorius, rectus femoris and the pectineus muscles. The femoral nerve innervates the iliacus, pectineus, sartorius and quadriceps femoris muscles, and supplies skin on the anterior thigh, anteromedial knee and medial leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      34.8
      Seconds
  • Question 17 - A 25-year-old guy who has had a knee-high plaster cast on his left...

    Correct

    • A 25-year-old guy who has had a knee-high plaster cast on his left leg for the past 5 weeks arrives at the emergency department complaining of numbness on the dorsum of his left foot and an inability to dorsiflex or evert his foot. You know that his symptoms are due to fibular nerve compression. Where is the fibular nerve located?

      Your Answer: Neck of fibula

      Explanation:

      Dorsiflexion and eversion of the foot are innervated by the deep fibular nerve and the superficial fibular nerve, respectively.

      The common fibular nerve runs obliquely downward along the lateral border of the popliteal fossa (medial to the biceps femoris) before branching at the neck of the fibula.

      Thus, it is prone to being affected during an impact injury or fracture to the bone or leg. Casts that are placed too high can also compress the fibular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      26.9
      Seconds
  • Question 18 - An 80-year-old female complains of chest pain characteristic of angina. A dose of...

    Incorrect

    • An 80-year-old female complains of chest pain characteristic of angina. A dose of glyceryl trinitrate (GTN) is administered that resolves the chest pain rapidly.

      Which ONE of the following is released on the initial metabolism of GTN?

      Your Answer: Cyclic AMP

      Correct Answer: Nitrite ions

      Explanation:

      Angina pectoris is the most common symptom of ischemic heart disease and presents with chest pain relieved by rest and nitro-glycerine.

      Nitrates are the first-line treatment to relieve chest pain caused by angina. The commonly used nitrates are:
      1. Glyceryl trinitrate
      2. Isosorbide dinitrate

      The nitrate drugs are metabolized in the following steps:
      1. Release Nitrite ions (NO2-), which are then converted to nitric oxide (NO) within cells.
      2. NO activates guanylyl cyclase, which causes an increase in the intracellular concentration of cyclic guanosine-monophosphate (cGMP) in vascular smooth muscle cells.
      3. Relaxation of vascular smooth muscle.

      Although nitrates are potent coronary vasodilators, their principal benefit in the management of angina results from a predominant mechanism of venous dilation:
      – Bigger veins hold more blood
      – Takes blood away from the left ventricle
      – Lowers LVEDV (preload), LA pressure
      – Less pulmonary oedema → improved dyspnoea

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      40.3
      Seconds
  • Question 19 - A 26-year old female comes to the Emergency Room with complaints of bloody...

    Correct

    • A 26-year old female comes to the Emergency Room with complaints of bloody stools. She reports that prior to the passage of bloody stools, she experienced a sharp pain during defecation. Medical history reveals that she has been experiencing constipation for the past 2 weeks. After completing her medical history and physical examination, the attending physician gives an initial diagnosis of an anal fissure.

      Which of the following nerves transmit painful sensation from the anus, resulting in the pain associated with anal fissure?

      Your Answer: Inferior rectal nerve

      Explanation:

      A fissure in ano is a tear in the anoderm distal to the dentate line. The pathophysiology of anal fissure is thought to be related to trauma from either the passage of hard stool or prolonged diarrhoea. A tear in the anoderm causes spasm of the internal anal sphincter, which results in pain, increased tearing, and decreased blood supply to the anoderm. The site of the anal fissure in the sensitive lower half of the anal canal, which is innervated by the inferior rectal nerve, results in reflex spasm of the external anal sphincter, aggravating the condition. Because of the intense pain, anal fissures may have to be examined under local anaesthesia.

      The inferior rectal nerve is a branch of the pudendal nerve. This nerve runs medially across the ischiorectal fossa and supplies the external anal sphincter, the mucous membrane of the lower half of the anal canal, and the perianal skin.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      45.4
      Seconds
  • Question 20 - Glomerular filtration rate can be calculated using any substance that: ...

    Correct

    • Glomerular filtration rate can be calculated using any substance that:

      Your Answer: is freely filtered and neither reabsorbed nor secreted by the nephron

      Explanation:

      Clearance of a substance can provide an accurate estimate of the glomerular filtration rate (GFR) provided that the substance is:freely filterednot reabsorbed in the nephronnot secreted in the nephronnot synthesised or metabolised by the kidney

    • This question is part of the following fields:

      • Physiology
      • Renal
      21.7
      Seconds
  • Question 21 - A 62-year-old woman has reduced urine output, nausea, and confusion. Renal function tests...

    Incorrect

    • A 62-year-old woman has reduced urine output, nausea, and confusion. Renal function tests and other investigations done leads to a diagnosis of acute kidney injury (AKI). Which one of these is consistent with a diagnosis of AKI?

      Your Answer: A sustained decrease in GFR of 25% or more within 12 months

      Correct Answer: A rise in serum creatinine of 26 μmol/L within 48 hours

      Explanation:

      AKI is diagnosed based on an acutely rising serum creatinine and/or reduction in urine output.

      • AKI can often be non-oliguric.

      AKI is present if any one or more of the following criteria is met:

      • A rise in serum creatinine of ≥26 micromol/L (≥0.3 mg/dL) within 48 hours

      • A rise in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the past 7 days (in practice you can use the lowest value from the past 3 months as the baseline for the patient)

      • Urine volume <0.5 ml/kg/hour for at least 6 hours.

       

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      48.1
      Seconds
  • Question 22 - A 22 year old professional athlete sustains an inversion injury to her left...

    Incorrect

    • A 22 year old professional athlete sustains an inversion injury to her left ankle during the 800m. Which of the following ligaments is most likely injured:

      Your Answer: Posterior talofibular ligament

      Correct Answer: Anterior talofibular ligament

      Explanation:

      Inversion injuries at the ankle in plantarflexion (such as when wearing high heels) are common, and typically result in damage to the lateral collateral ligament of the ankle, made up of the anterior talofibular, the calcaneofibular and the posterior talofibular ligaments. The anterior talofibular and the calcaneofibular ligaments are most commonly injured, and the posterior talofibular ligament rarely. The spring ligament supports the head of the talus, the deltoid ligament supports the medial aspect of the ankle joint, and the long and short plantar ligaments are involved in maintaining the lateral longitudinal arch of the foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      26.1
      Seconds
  • Question 23 - Which of the following microbes attaches to host cells by its haemagglutinin antigen:...

    Incorrect

    • Which of the following microbes attaches to host cells by its haemagglutinin antigen:

      Your Answer: Streptococcus pneumoniae

      Correct Answer: Influenza virus

      Explanation:

      Hemagglutinin (HA) or Haemagglutinin (BE) is an antigenic glycoprotein found on the surface of the influenza viruses. It is responsible for binding the virus to the cell that is being infected. The name hemagglutinin comes from the protein’s ability to cause red blood cells (erythrocytes) to clump together (agglutinate) in vitro.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      26
      Seconds
  • Question 24 - An elderly patient presents to ED following a fall after feeling light headed...

    Incorrect

    • An elderly patient presents to ED following a fall after feeling light headed when standing up. You are reviewing his medication and note that he is taking a high dose of furosemide. Loop diuretics act primarily at which of the following sites in the nephron:

      Your Answer: Descending limb

      Correct Answer: Thick ascending limb

      Explanation:

      Loop diuretics inhibit the Na+/K+/2Cl- symporter on the luminal membrane in the thick ascending limb of the loop of Henle, thus preventing reabsorption of NaCl and water. These agents reduce reabsorption of Cl- and Na+ and increase Ca2+ excretion and loss of K+ and Mg2+.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      21.9
      Seconds
  • Question 25 - A 58-year-old man with a long history of poorly controlled hypertension complains of...

    Incorrect

    • A 58-year-old man with a long history of poorly controlled hypertension complains of a headache and vision blurring today. In triage, his blood pressure is 210/192 mmHg. A CT head scan is scheduled to rule out the possibility of an intracranial haemorrhage. You make the diagnosis of hypertensive encephalopathy and rush the patient to reus to begin blood pressure-lowering treatment. He has a history of brittle asthma, for which he has been admitted to the hospital twice in the last year.

      Which of the following is the patient's preferred drug treatment?

      Your Answer: Labetalol

      Correct Answer: Nicardipine

      Explanation:

      End-organ damage (e.g. encephalopathy, intracranial haemorrhage, acute myocardial infarction or ischaemia, dissection, pulmonary oedema, nephropathy, eclampsia, papilledema, and/or angiopathic haemolytic anaemia) characterises a hypertensive emergency (also known as ‘accelerated hypertension’ or malignant hypertension’ It’s a life-threatening condition that necessitates rapid blood pressure reduction to avoid end-organ damage and a negative outcome.

      Hypertensive encephalopathy is a syndrome that includes headaches, seizures, visual changes, and other neurologic symptoms in people who have high blood pressure. It is reversible if treated quickly, but it can progress to coma and death if not treated properly.

      Any patient with suspected hypertensive encephalopathy should have an urgent CT scan to rule out an intracranial haemorrhage, as rapid blood pressure reduction could be dangerous in these circumstances.

      The drug of choice is labetalol, which reduces blood pressure steadily and consistently without compromising cerebral blood flow.
      An initial reduction of approximately 25% in mean arterial pressure (MAP) over an hour should be aimed for, followed by a further controlled MAP reduction over the next 24 hours. In patients who are unable to take beta-blockers, nicardipine can be used as a substitute.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      8.7
      Seconds
  • Question 26 - Which of the following is an ECG change typically associated with hyperkalaemia: ...

    Correct

    • Which of the following is an ECG change typically associated with hyperkalaemia:

      Your Answer: Wide QRS complex

      Explanation:

      Hyperkalaemia causes a rapid reduction in resting membrane potential leading to increased cardiac depolarisation and muscle excitability. This in turn results in ECG changes which can rapidly progress to ventricular fibrillation or asystole. Very distinctive ECG changes that progressively change as the K+level increases:
      K+>5.5 mmol/l – peaked T waves (usually earliest sign of hyperkalaemia), repolarisation abnormalities
      K+>6.5 mmol/l – P waves widen and flatten, PR segment lengthens, P waves eventually disappear
      K+>7.0 mmol/l – Prolonged QRS interval and bizarre QRS morphology, conduction blocks (bundle branch blocks, fascicular blocks), sinus bradycardia or slow AF, development of a sine wave appearance (a pre-terminal rhythm)
      K+>9.0 mmol/l – Cardiac arrest due to asystole, VF or PEA with a bizarre, wide complex rhythm.

    • This question is part of the following fields:

      • Physiology
      • Renal
      9.8
      Seconds
  • Question 27 - Regarding the extensor carpi ulnaris muscle, which of the following statements is true?...

    Incorrect

    • Regarding the extensor carpi ulnaris muscle, which of the following statements is true?

      Your Answer: It assists with the abduction of the hand at the wrist joint

      Correct Answer: It receives its blood supply from the ulnar artery

      Explanation:

      Extensor carpi ulnaris is a fusiform muscle in the posterior forearm. It spans between the elbow and base of the little finger. This muscle belongs to the superficial forearm extensor group, along with anconaeus, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum and extensor digiti minimi muscles.

      Like all the muscles of this compartment, extensor carpi ulnaris works as an extensor of the wrist. Moreover, due to its specific course, this muscle also acts to adduct the hand.

      Extensor carpi ulnaris is innervated by the posterior interosseous nerve (C7, C8), a branch of the deep division of the radial nerve. The radial nerve stems from the posterior cord of the brachial plexus.

      Blood supply to the extensor carpi ulnaris muscle is provided by branches of the radial recurrent and posterior interosseous arteries, which stem from the radial and ulnar arteries, respectively.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      43.3
      Seconds
  • Question 28 - An 80-year-old woman with history of hypertension, diabetes, and ischemic stroke, presents with...

    Correct

    • An 80-year-old woman with history of hypertension, diabetes, and ischemic stroke, presents with left-sided hemiplegia of the face, tongue, and limbs and right-sided deficits in motor eye activity. A CT scan was ordered and showed a right-sided stroke.

      Branches of which of the following arteries are most likely implicated in the case?

      Your Answer: Basilar artery

      Explanation:

      Weber syndrome is a midbrain stroke characterized by crossed hemiplegia along with oculomotor nerve deficits and it occurs with the occlusion of the median and/or paramedian perforating branches of the basilar artery.

      Typical clinical findings include ipsilateral CN III palsy, ptosis, and mydriasis (such as damage to parasympathetic fibres of CN III) with contralateral hemiplegia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      22.9
      Seconds
  • Question 29 - Which of the following immunoglobulins is predominant in saliva: ...

    Incorrect

    • Which of the following immunoglobulins is predominant in saliva:

      Your Answer: IgM

      Correct Answer: IgA

      Explanation:

      Immunoglobulin A is predominant in saliva.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      14.5
      Seconds
  • Question 30 - A 56-year-old female visits her cardiologist complaining of a condition that has started...

    Incorrect

    • A 56-year-old female visits her cardiologist complaining of a condition that has started since he started her on amiodarone for atrial arrhythmia. The cardiologist recognised that she is experiencing a side effect of amiodarone.

      Which one of the following conditions will this woman NOT have?

      Your Answer: Peripheral neuropathy

      Correct Answer: Xanthopsia

      Explanation:

      Amiodarone is a class III potassium channel blocker used to treat multiple types of arrhythmias.

      Side effects include:
      1. pulmonary fibrosis
      2. blue discolouration of the skin
      3. phototoxicity
      4. corneal deposits
      5. hepatic necrosis
      6. thyroid dysfunction
      7. sleep disturbances
      8. peripheral neuropathy.

      Xanthopsia is a condition where the patient complains of seeing yellow lines and is seen in digoxin overdose.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      18.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pathology (1/5) 20%
Pathology Of Infections (0/1) 0%
Endocrine Physiology (1/1) 100%
Physiology (4/5) 80%
Gastrointestinal (0/2) 0%
Pharmacology (1/10) 10%
General Pathology (0/2) 0%
Endocrine Pharmacology (0/1) 0%
Haematology (0/1) 0%
CNS Pharmacology (0/1) 0%
Microbiology (1/3) 33%
Principles (0/2) 0%
Cardiovascular Pharmacology (1/4) 25%
Fluids & Electrolytes (0/1) 0%
Respiratory Pharmacology (0/1) 0%
Pathogens (1/1) 100%
Renal (3/3) 100%
Immune Responses (1/1) 100%
Anatomy (5/7) 71%
Upper Limb (1/2) 50%
Lower Limb (2/3) 67%
Abdomen And Pelvis (1/1) 100%
Cardiovascular (0/1) 0%
Central Nervous System (1/1) 100%
Passmed