00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
Retry this test Dashboard

  • Question 1 - A 60-year-old man with trauma to his cervical spine suffers from damage to...

    Correct

    • A 60-year-old man with trauma to his cervical spine suffers from damage to the ansa cervicalis, resulting to paresis of his infrahyoid muscles.

      All of the following are considered infrahyoid muscles, except:

      Your Answer: Mylohyoid

      Explanation:

      Infrahyoid muscles are also known as “strap muscles” which connect the hyoid, sternum, clavicle and scapula. They are located below the hyoid bone on the anterolateral surface of the thyroid gland and are involved in movements of the hyoid bone and thyroid cartilage during vocalization, swallowing and mastication. They are composed of four paired muscles, organized into two layers.

      Superficial layer consists of the sternohyoid and omohyoid
      Deep layer consists of the sternothyroid and thyrohyoid.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      88.7
      Seconds

  • Question 2 - A 39-year-old man with a long history of depression presents after intentionally overdoing...

    Correct

    • A 39-year-old man with a long history of depression presents after intentionally overdoing his heart medication. Verapamil immediate-release 240 mg is the tablet he takes for this condition, he says. He took the pills about 30 minutes ago, but his wife discovered him right away and rushed him to the emergency room.

      At the moment, he is completely symptom-free. When it comes to this type of overdose, how long does it usually take for symptoms to appear?

      Your Answer: 1-2 hours

      Explanation:

      Overdosing on calcium-channel blockers should always be taken seriously and regarded as potentially fatal. Verapamil and diltiazem are the two most lethal calcium channel blockers in overdose. These work by binding the alpha-1 subunit of L-type calcium channels, preventing calcium from entering the cell. In cardiac myocytes, vascular smooth muscle cells, and islet beta-cells, these channels play an important role.

      >10 tablets of verapamil (160 mg or 240 mg immediate or sustained-release capsules) or diltiazem can cause serious toxicity (180 mg, 240 mg or 360 mg immediate or sustained-release capsules)

      In children, 1-2 tablets of verapamil or diltiazem (immediate or sustained-release)

      Symptoms usually appear within 1-2 hours of ingestion with standard preparations. However, with slow-release preparations, significant toxicity may take 12-16 hours to manifest, with peak effects occurring after 24 hours.

      The following are the main clinical features of calcium-channel blocker overdose:
      Nausea and vomiting
      Hypotension
      Bradycardia and first-degree heart block
      Myocardial ischaemia and stroke
      Renal failure
      Pulmonary oedema
      Hyperglycaemia

      The following are some of the most important bedside investigations to conduct:
      Blood glucose
      ECG
      Arterial blood gas
      Other investigations that can be helpful include
      Urea & electrolytes
      Chest X-ray (pulmonary oedema)
      Echocardiography

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      159.8
      Seconds

  • Question 3 - You've been summoned to the resuscitation area to assist a patient who is...

    Incorrect

    • You've been summoned to the resuscitation area to assist a patient who is having a seizure. As part of the treatment protocol, a benzodiazepine dose is given.

      Which of the following statements about the use of benzodiazepines in seizures is correct?

      Your Answer: IV diazepam is the first-line drug

      Correct Answer: Lorazepam can be given by the rectal route

      Explanation:

      A single dose of IV benzodiazepine will terminate the seizure in 60 to 80 percent of patients who present with seizures.

      Because benzodiazepines are lipid-soluble, they cross the blood-brain barrier quickly. This explains their quick onset of action.

      As a first-line treatment, IV lorazepam should be given. If IV lorazepam is not available, IV diazepam can be used instead, and buccal midazolam can be used if intravenous access cannot be established quickly. Lorazepam can be administered via the rectal route, but it is less reliable and has a lower absorption rate and bioavailability.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      41.3
      Seconds

  • Question 4 - Which one of the listed cells are typically found in a granuloma? ...

    Incorrect

    • Which one of the listed cells are typically found in a granuloma?

      Your Answer: Langerhan’s cells

      Correct Answer: Epithelioid cells

      Explanation:

      Typically, a granuloma has Langhan’s cells (large multinucleated cells) surrounded by epithelioid cell aggregates, T lymphocytes and fibroblasts.

      Antigen presenting monocytic cells are found in the skin are known as Langerhan’s cells.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      8.4
      Seconds

  • Question 5 - Which of the following is an example of discrete data: ...

    Incorrect

    • Which of the following is an example of discrete data:

      Your Answer: Disease staging system

      Correct Answer: Number of children

      Explanation:

      Discrete data is quantitative data that can only take whole numerical values e.g. number of children, number of days missed from work.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      19.7
      Seconds

  • Question 6 - A 72-year-old man has a past medical history of diverticular disease. He now...

    Incorrect

    • A 72-year-old man has a past medical history of diverticular disease. He now presents in the clinic with crampy abdominal pain. The nurse at the triage suggests prescribing hyoscine butyl bromide to help relieve the abdominal pain. However, you do not agree with this medication, as you can see on his chart that the patient has several other comorbidities.

      Out of the following, what is NOT a contraindication to using hyoscine butyl bromide?

      Your Answer: Closed-angle glaucoma

      Correct Answer: Prostatic hyperplasia

      Explanation:

      Hyoscine butylbromide is an antispasmodic drug that blocks muscarinic receptors and reduces intestinal motility. It is used for gastrointestinal and genitourinary smooth muscle spasms and symptomatic relief of IBS.

      It has the following contraindications:
      1. Closed-angle glaucoma
      2. Gastrointestinal obstruction
      3. Intestinal atony
      4. Paralytic ileus
      5. Toxic megacolon
      6. Severe ulcerative colitis
      7. Significant bladder outflow obstruction
      8. Urinary retention
      9. Myasthenia gravis

      Use cautiously in the following conditions:
      1. Acute myocardial infarction (in adults)
      2. Arrhythmias (may be worsened)
      3. Autonomic neuropathy
      4. Hypertension
      5. Cardiac insufficiency (due to association with tachycardia)
      6. Congestive cardiac failure (maybe worsened)
      7. Cardiac surgery (due to association with tachycardia)
      8. Gastro-oesophageal reflux disease
      9. Ulcerative colitis
      10. Prostatic hyperplasia
      11. Use in children (increased risk of side effects)

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      37.2
      Seconds

  • Question 7 - Which of the following is NOT an adverse effect of amitriptyline: ...

    Incorrect

    • Which of the following is NOT an adverse effect of amitriptyline:

      Your Answer: Narrow-angle glaucoma

      Correct Answer: Hypokalaemia

      Explanation:

      Adverse effects include:
      Antimuscarinic effects: Dry mouth, Blurred vision, Constipation, Urinary retention, Sedation, Confusion
      Cardiovascular effects: Heart block, Arrhythmias, Tachycardia, Postural hypotension, QT-interval prolongation, Hepatic impairment, Narrow-angle glaucoma

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      16.4
      Seconds

  • Question 8 - Which of the following statements is correct with regards to insulin receptors? ...

    Incorrect

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

      Your Answer: Insulin receptors are only present on cells of the liver.

      Correct Answer: Insulin has its intracellular effects via activation of tyrosine kinase.

      Explanation:

      Most cells have insulin receptors present on them which can be sequestered into the cell to inactivate them. These receptors consist of two extracellular alpha subunits which contain the insulin-binding site and two transmembrane beta subunits. Because insulin is a polypeptide hormone, it must act via cell surface receptors as it is unable to readily cross the cell membrane. On binding to the receptor, the beta subunit of insulin autophosphorylation, which activates tyrosine kinase. As a result, there is an intracellular cascade of phosphorylation, causing a translocation of the glucose transporter GLUT4 and GLUT-1 to the plasma membrane of the affected cell. This facilitates glucose entry.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      22.4
      Seconds

  • Question 9 - A blood culture was performed from a sample taken from a patient. It...

    Correct

    • A blood culture was performed from a sample taken from a patient. It was noted that a Gram-positive coccus organism was grown.

      Among the following microorganisms, which is considered an example of a Gram-positive coccus?

      Your Answer: Staphylococcus aureus

      Explanation:

      Bacillus cereus = Gram-positive bacillus
      Neisseria meningitidis = Gram-negative coccus
      Salmonella enterica & Escherichia coli = Gram-negative bacilli

      In Gram staining, crystal violet is a purple stain that is used to stain the bacteria first. The stained bacteria are decolorized and then stained with a red stain, which is safranin. Bacteria with thick cell walls keep the purple stain and are called Gram-positive. Thin-walled bacteria are easily decolorized so when safranin, the red stain, is placed on the organisms, they become red or Gram-negative.
      The Staphylococci that are associated with infections in humans are colonizers of various skin and mucosal surfaces. Because the carrier state is common among the human population, infections are frequently acquired when the colonizing strain gains entrance to a normally sterile site as a result of trauma or abrasion to the skin or mucosal surface.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      11.6
      Seconds

  • Question 10 - You are instructed by a senior to administer Mannitol to an RTA patient...

    Correct

    • You are instructed by a senior to administer Mannitol to an RTA patient with increased intracranial pressure.

      Mannitol is a low molecular weight compound that freely filters at the glomerulus and is not reabsorbed.
      Out of the following, which is a contraindication to the use of mannitol?

      Your Answer: Severe pulmonary oedema

      Explanation:

      Mannitol is the most widely used osmotic diuretic that is most commonly used to reduce cerebral oedema and intracranial pressure.
      It is recommended to use mannitol for the reduction of CSF pressure/cerebral oedema in a dose of 0.25-2 g/kg as an intravenous infusion over 30-60 minutes. This can be repeated 1-2 times after 4-8 hours if needed.

      Mannitol has several contraindications and some of them are listed below:
      1. Anuria due to renal disease
      2. Acute intracranial bleeding (except during craniotomy)
      3. Severe cardiac failure
      4. Severe dehydration
      5. Severe pulmonary oedema or congestion
      6. Known hypersensitivity to mannitol

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      29.5
      Seconds

  • Question 11 - The mechanism of action of abciximab is by: ...

    Correct

    • The mechanism of action of abciximab is by:

      Your Answer: Blocking the binding of fibrinogen to GPIIb/IIIa receptor sites

      Explanation:

      Abciximab is a glycoprotein IIb/IIIa inhibitors and prevents platelet aggregation by blocking the binding of fibrinogen to receptors on platelets.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      56.4
      Seconds

  • Question 12 - Oculomotor (CN III) palsy with sparing of the pupillary reflex is most likely...

    Incorrect

    • Oculomotor (CN III) palsy with sparing of the pupillary reflex is most likely caused by which of the following:

      Your Answer: Aneurysm of the posterior communicating artery

      Correct Answer: Diabetes mellitus

      Explanation:

      Compressive causes of CN III palsy cause early pupillary dilatation because the parasympathetic fibres run peripherally in the nerve and are easily compressed. In diabetes mellitus the lesions are ischaemic rather than compressive and therefore typically affect the central fibres resulting in pupillary sparing.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      14
      Seconds

  • Question 13 - An elderly man with chronic heart and lung disease develops Legionnaires' disease. Which...

    Incorrect

    • An elderly man with chronic heart and lung disease develops Legionnaires' disease. Which of the following clinical features is NOT typical of Legionnaires' disease:

      Your Answer: Progressive dyspnoea

      Correct Answer: Confusion

      Explanation:

      Legionella pneumophilais a Gram negative bacterium that is found in natural water supplies and in the soil, transmitted predominantly via inhalation of aerosols generated from contaminated water (direct person-to-person spread of infected patients does not occur). It is the cause of Legionnaires’ disease. Outbreaks of Legionnaires’ disease have been linked to poorly maintained air conditioning systems, whirlpool spas and hot tubs.

      The clinical features of the pneumonic form of Legionnaires’ disease include:
      Mild flu-like prodrome for 1-3 days
      Cough (usually non-productive and occurs in approximately 90%)
      Pleuritic chest pain
      Haemoptysis
      Headache
      Nausea, vomiting and diarrhoea
      Anorexia

      Legionella pneumophilainfections can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used.

      The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur with Legionnaires’ disease and will result in hyponatraemia as is seen in this case.
      Legionella pneumophilainfections are resistant to amoxicillin but can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used. The majority of cases of Legionnaires’ disease are caused by Legionella pneumophila, however many other species of Legionella have been identified.
      Legionella longbeachae is another less commonly encountered species that has also been implicated in outbreaks. It is predominantly found in soil and potting compost, and has caused outbreaks of Pontiac fever, the non-respiratory and less severe variant of Legionnaires’ disease.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      23.4
      Seconds

  • Question 14 - Which of the following statements about neutrophils is TRUE: ...

    Correct

    • Which of the following statements about neutrophils is TRUE:

      Your Answer: Neutrophils are typically the first immune cell to arrive to a site of injury.

      Explanation:

      Neutrophils are the most numerous peripheral blood leukocytes, accounting for 50-70 percent of all circulating white cells. Neutrophils have a compact nucleus with two to five lobes and a pale cytoplasm with an irregular shape containing numerous fine pink-blue or grey-blue granules. The granules are classified as primary, which emerges during the promyelocyte stage, and secondary, which develop at the myelocyte stage and predominate in the mature nucleus.

      The lifespan of neutrophils in the blood is only 6 – 10 hours. In response to tissue damage, cytokines and complement proteins, neutrophils migrate from the bloodstream to the site of insult within minutes, where they destroy pathogens by phagocytosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      17.9
      Seconds

  • Question 15 - Anatomical barriers to infection include all of the following EXCEPT: ...

    Correct

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

      Your 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
      31.7
      Seconds

  • Question 16 - Regarding meningococcal meningitis, which of the following statements is CORRECT: ...

    Correct

    • Regarding meningococcal meningitis, which of the following statements is CORRECT:

      Your Answer: Infection occurs most commonly below the age of 5 years.

      Explanation:

      About half of meningococcal disease occurs in children aged less than five years, and babies are at the highest risk because their immune systems have not yet fully developed. There is a second, smaller increase in risk for older adolescents, mainly for social and behavioural reasons. Infection is most common in winter months. Antibiotics should be given as soon as the diagnosis is suspected (ideally cultures should be performed first but this should not delay treatment), and ceftriaxone/cefuroxime is the first line antibiotic. Only healthcare workers who have been directly exposed to large particle droplets/secretions from the respiratory tract of the index case should receive prophylaxis.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      25.3
      Seconds

  • Question 17 - All of the following are actions of insulin except: ...

    Incorrect

    • All of the following are actions of insulin except:

      Your Answer: Decreased protein degradation

      Correct Answer: Increased gluconeogenesis

      Explanation:

      Major Actions of Insulin:
      ↑ Glucose uptake into cells
      ↑ Glycogenesis
      ↓ Glycogenolysis
      ↓ Gluconeogenesis
      ↑ Protein synthesis
      ↓ Protein degradation
      ↑ Fat deposition
      ↓ Lipolysis
      ↓ Ketoacid production
      ↑ K+ uptake into cells

      Major Actions of Glucagon:
      ↓ Glycogenesis
      ↑ Glycogenolysis
      ↑ Gluconeogenesis
      ↓ Fatty acid synthesis
      ↑ Lipolysis
      ↑ Ketoacid production

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      28.9
      Seconds

  • Question 18 - Which of the following side effects has limited the use of etomidate as...

    Incorrect

    • Which of the following side effects has limited the use of etomidate as an intravenous induction agent:

      Your Answer: Increased intracranial pressure

      Correct Answer: Adrenocortical suppression

      Explanation:

      Etomidate causes the least cardiovascular depression of the intravenous induction agents, with only a small reduction in the cardiac output and blood pressure. In the past, etomidate was widely used to induce anaesthesia in the shocked, elderly or cardiovascularly unstable patient. However, more recently it has become less popular as a single induction dose blocks the normal stress-induced increase in adrenal cortisol production for 4 – 8 hours, and up to 24 hours in elderly and debilitated patients. Although no increase in mortality has been identified following a single dose during induction of anaesthesia, the use of etomidate has declined due to a perceived potential morbidity.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      21.4
      Seconds

  • Question 19 - Following a bee sting, a 8-year old boy was transported to resus with...

    Incorrect

    • Following a bee sting, a 8-year old boy was transported to resus with symptoms and signs of an anaphylactic reaction. You decide to administer adrenaline IM stat. What is the recommended dose of intramuscular adrenaline?

      Your Answer: 0.5 mL of 1:1000

      Correct Answer: 0.3 mL of 1:1000

      Explanation:

      Anaphylaxis is a type I hypersensitivity reaction that is severe and life-threatening. It is marked by the fast onset of life-threatening airway and/or circulatory issues, which are generally accompanied by skin and mucosal abnormalities. When an antigen attaches to specific IgE immunoglobulins on mast cells, degranulation and the release of inflammatory mediators takes place (e.g. histamine, prostaglandins, and leukotrienes).

      The most important medicine for treating anaphylactic responses is adrenaline. It decreases oedema and reverses peripheral vasodilation as an alpha-adrenergic receptor agonist. Its beta-adrenergic effects widen the bronchial airways, enhance the force of cardiac contraction, and inhibit the release of histamine and leukotriene. The first medicine to be given is adrenaline, and the IM route is optimal for most people.

      In anaphylaxis, age-related dosages of IM adrenaline are:
      150 mcg (0.15 mL of 1:1000) for a child under 6 years
      300 mcg (0.3 mL of 1:1000) for a child aged 6 to 12 years
      500 mcg (0.5 mL of 1:1000) for children aged 12 and above
      500 mcg for adults (0.5 mL of 1:1000)

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      13.3
      Seconds

  • Question 20 - A 22-year-old man arrives at the emergency department with a sore throat, low-grade...

    Correct

    • A 22-year-old man arrives at the emergency department with a sore throat, low-grade fever, and malaise. His partner has infectious mononucleosis, which was recently diagnosed. In this situation, which of the following cells is the most proliferative:

      Your Answer: Lymphocytes

      Explanation:

      Histologic findings in EBV infectious mononucleosis: Oropharyngeal epithelium demonstrates an intense lymphoproliferative response in the cells of the oropharynx. The lymph nodes and spleen show lymphocytic infiltration primarily in the periphery of a lymph node.
      Relative lymphocytosis (≥ 60%) plus atypical lymphocytosis (≥ 10%) are the characteristic findings of Epstein Barr virus (EBV) infectious mononucleosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      16
      Seconds

  • Question 21 - A medical student is reviewing the chart of a patient who has recently...

    Correct

    • A medical student is reviewing the chart of a patient who has recently been diagnosed with leukaemia. The chief resident asks him to identify ONE feature that will most support acute leukaemia diagnosis in contrast to chronic leukaemia.

      Which one of the following options will he pick?

      Your Answer: The patient is a child

      Explanation:

      Acute lymphocytic leukaemia (ALL) is more common in children than chronic leukaemias, which generally occur in adults. Bone marrow failure occurs early on in the course of the disease in acute leukaemias, and there is the massive proliferation of undifferentiated cells with functioning cells being crowded out. Hepatosplenomegaly occurs in both acute and chronic forms of leukaemia and is not a differentiating feature.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      55.1
      Seconds

  • Question 22 - If a patient dislocated his right shoulder and has been referred to the...

    Correct

    • 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: 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
      38.6
      Seconds

  • Question 23 - A 53-year-old man arrives at the emergency department complaining of visual impairment in...

    Incorrect

    • A 53-year-old man arrives at the emergency department complaining of visual impairment in his right eye. On examination, you notice that neither his right nor left pupil constricts when you shine a light in his right eye. When you flash a light in his left eye, the pupils of both his left and right eyes constrict. Which of the following nerves is the most likely to be affected:

      Your Answer: Oculomotor nerve

      Correct Answer: Optic nerve

      Explanation:

      In full optic nerve palsy, the afferent pupillary light reflex is lost. Because the afferent optic nerve does not sense light flashed in the afflicted eye, the ipsilateral direct and contralateral consensual reflexes are gone. However, the contralateral direct and ipsilateral consensual reflexes are intact because the efferent oculomotor nerve is normal.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      22.5
      Seconds

  • Question 24 - Which of the following is the most common cause of hyperthyroidism: ...

    Incorrect

    • Which of the following is the most common cause of hyperthyroidism:

      Your Answer: Toxic thyroid adenoma

      Correct Answer: Graves disease

      Explanation:

      Graves disease is the most common cause of hyperthyroidism. It is an autoimmune disease in which autoantibodies against TSH receptors are produced. These antibodies bind to and stimulate these TSH receptors leading to an excess production of thyroid hormones. Therefore, the signs and symptoms of Graves disease are the same as those of hyperthyroidism, reflecting the actions of increased circulating levels of thyroid hormones: increased heat production, weight loss, increased 02 consumption and cardiac output and exophthalmos (bulging eyes, not drooping eyelids). TSH levels will be decreased (not increased) as a result of the negative feedback effect of increased T3 levels on the anterior pituitary.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      17
      Seconds

  • Question 25 - A blood culture was performed from a sample taken from a patient. It...

    Incorrect

    • A blood culture was performed from a sample taken from a patient. It was noted that a Gram-negative coccus organism was grown.

      Among the following microorganisms, which is considered an example of a Gram-negative coccus?

      Your Answer: Escherichia coli

      Correct Answer: Neisseria menigitidis

      Explanation:

      Staphylococcus aureus = Gram-positive coccus
      Bacillus cereus = Gram-positive bacillus
      Campylobacter jejuni = Gram-negative bacillus
      Escherichia coli = Gram-negative bacillus

      In Gram staining, crystal violet is a purple stain that is used to stain the bacteria first. The stained bacteria are decolorized and then stained with a red stain, which is safranin. Bacteria with thick cell walls keep the purple stain and are called Gram-positive. Thin-walled bacteria are easily decolorized so when safranin, the red stain, is placed on the organisms, they become red or Gram-negative.
      Neisseria species appear as Gram-negative diplococci because they form pairs and their adjacent ends are flattened that is why they are also described to have a coffee-bean or kidney-bean shape.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      19.6
      Seconds

  • Question 26 - A 32-year-old female is diagnosed case of bipolar disorder and is on medication....

    Incorrect

    • A 32-year-old female is diagnosed case of bipolar disorder and is on medication. She presents to her psychiatric team with symptoms of severe depression. She is currently taking Lithium.

      Out of the following, which is TRUE regarding lithium?

      Your Answer: Levels should be checked one month after starting therapy

      Correct Answer: It commonly causes a tremor

      Explanation:

      Lithium is the drug of choice for bipolar disorders but is commonly associated with side effects and toxicity.

      Fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy with Lithium. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer. Lithium tremors are more common with older age, presumably due to the additive effects of age-related essential tremors.

      Option The normal therapeutic range is 2.0-2.5 mmol/l: Lithium should be carefully monitored as it has a very low therapeutic index. The normal therapeutic range is 0.4-0.8 mmol/l. Levels should be checked one week after starting therapy and one week after every change in dosage. (Option Levels should be checked one month after starting therapy)

      Option It can induce hyperthyroidism: Lithium has a known effect on thyroid function. Lithium decreases the production of T4 and T3 and commonly causes hypothyroidism. More rarely, lithium causes hyperthyroidism due to thyroiditis.

      Option It can induce diabetes mellitus: Lithium can induce nephrogenic diabetes insipidus but not diabetes mellitus.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      22.2
      Seconds

  • Question 27 - Regarding a cohort study, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding a cohort study, which of the following statements is INCORRECT:

      Your Answer: The usual outcome measure is the relative risk.

      Correct Answer: It is useful for rare diseases.

      Explanation:

      A cohort study is a longitudinal, prospective, observational study that follows a defined group (cohort) matched to unexposed controls for a set period of time and investigates the effect of exposure to a risk factor on a particular future outcome. The usual outcome measure is the relative risk (risk ratio). A large sample size is required for a rare outcome of interest so it is not useful for rare diseases.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      19.3
      Seconds

  • Question 28 - Reed-Sternberg cells are characteristic of which of the following malignancies: ...

    Correct

    • Reed-Sternberg cells are characteristic of which of the following malignancies:

      Your Answer: Hodgkin lymphoma

      Explanation:

      Lymphomas are a group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and other lymphoid tissue and cause the characteristic clinical feature of lymphadenopathy. The major subdivision of lymphomas is into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) and this is based on the histological presence of Reed-Sternberg cells present in HL. Hodgkin lymphoma can present at any age but is rare in children and has a peak incidence in young adults. There is an almost 2 : 1 male predominance. Most patients present with painless, asymmetrical, firm and discrete enlargement of superficial lymph nodes. Cervical nodes are involved in 60-70% of cases, axillary nodes in 10-15% and inguinal nodes in 6-12%. Modest splenomegaly occurs during the course of the disease in 50% of patients; the liver may also be enlarged. Bone marrow failure involvement is unusual in early disease. The prognosis depends on age, stage and histology, but overall approximately 85% of patients are cured. Alcohol‐induced pain and pruritus are two well‐known but rare symptoms in HL.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      11.8
      Seconds

  • Question 29 - What is the mechanism of action of captopril: ...

    Correct

    • What is the mechanism of action of captopril:

      Your Answer: Angiotensin-converting enzyme inhibitor

      Explanation:

      Captopril is an angiotensin-converting enzyme (ACE) inhibitor, which inhibits the conversion of angiotensin I to angiotensin II.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      7.5
      Seconds

  • Question 30 - Which of the following drugs decreases plasma-theophylline levels: ...

    Correct

    • Which of the following drugs decreases plasma-theophylline levels:

      Your Answer: Carbamazepine

      Explanation:

      Examples of enzyme-inhibiting drugs (raise plasma theophylline level):
      Erythromycin
      Clarithromycin
      Ciprofloxacin
      Fluconazole
      Verapamil
      Allopurinol
      Cimetidine
      Examples of enzyme-inducing drugs (lower plasma theophylline level):
      Primidone
      Phenobarbital
      Carbamazepine
      Phenytoin
      Ritonavir
      Rifampicin
      St John’s Wort

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      10.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (2/4) 50%
Head And Neck (1/1) 100%
Cardiovascular Pharmacology (2/2) 100%
Pharmacology (5/11) 45%
CNS Pharmacology (0/2) 0%
General Pathology (0/1) 0%
Pathology (4/5) 80%
Evidence Based Medicine (0/2) 0%
Statistics (0/1) 0%
Gastrointestinal Pharmacology (0/1) 0%
Central Nervous System (0/1) 0%
Endocrine (0/3) 0%
Physiology (0/3) 0%
Microbiology (3/5) 60%
Principles Of Microbiology (1/2) 50%
Cardiovascular (2/2) 100%
Cranial Nerve Lesions (0/2) 0%
Pathogens (1/2) 50%
Immune Responses (2/2) 100%
Principles (1/1) 100%
Anaesthesia (0/1) 0%
Respiratory Pharmacology (0/1) 0%
Haematology (2/2) 100%
Upper Limb (1/1) 100%
Study Methodology (0/1) 0%
Respiratory (1/1) 100%
Passmed
Retry this test Dashboard