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  • Question 1 - Regarding cytotoxic T cells, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: They only recognise antigen in associated with HLA class II molecules.

      Correct 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
      43.9
      Seconds
  • Question 2 - In the extrinsic pathway of the coagulation cascade, the tenase complex is: ...

    Incorrect

    • In the extrinsic pathway of the coagulation cascade, the tenase complex is:

      Your Answer:

      Correct Answer: Factor VIIa-tissue factor complex

      Explanation:

      The extrinsic pathway for initiating the formation of prothrombin activator begins with a traumatized vascular wall or traumatized extravascular tissues that come in contact with the blood. Exposed and activated by vascular injury, with plasma factor VII. The extrinsic tenase complex, factor VIIa-tissue factor complex, activates factor X to factor Xa.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds
  • Question 3 - A 50-year-old man from Russia presents with a history of cough with blood-stained...

    Incorrect

    • A 50-year-old man from Russia presents with a history of cough with blood-stained sputum, fever, night sweats, and weight loss. Suspecting tuberculosis, you begin investigations.

      All the following statements regarding tuberculosis (TB) are true EXCEPT?

      Your Answer:

      Correct Answer: Corticosteroid use is not a risk factor for developing TB

      Explanation:

      Immunosuppressants like corticosteroids may be an important risk factor for developing tuberculosis.

      All of the other statements are true.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 4 - A 32 year old man is brought to ED having been thrown off...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds
  • Question 5 - A clinical audit cycle comprises of 5 steps. Each of these processes are...

    Incorrect

    • A clinical audit cycle comprises of 5 steps. Each of these processes are listed below:
      Which is the correct order that these should occur?

      1. Observation of practice and collection of data
      2. Identification of the problem
      3. Implementation of change
      4. Definition of criteria and setting of standards
      5. Analysis of data and comparison of performance with the criteria and standards

      Your Answer:

      Correct Answer: 2,4,1,5,3

      Explanation:

      An audit assesses if a certain aspect of health care is attaining a recognized standard. This lets care providers and patients know where their service is doing well, and where there could be improvements. The aim is to achieve quality improvement and improve outcomes for patients.

      Audits are a quality improvement measure and one of the 7 pillars of clinical governance. It allows organizations to continually work toward improving quality of care by showing them where they are falling short, allows them to implement improvements, and reaudit or close the audit cycle to see if beneficial change has taken place.

      Clinical audits are a cycle with several steps:

      1. Identification of the problem
      2. Definition of criteria and setting of standards
      3. Observation of practice and collection of data
      4. Analysis of data and comparison of performance with the criteria and standards
      5. Implementation of change

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds
  • Question 6 - Thyroid cancer has spread to the regional lymph nodes of a patient as...

    Incorrect

    • Thyroid cancer has spread to the regional lymph nodes of a patient as seen in a staging CT scan.

      The lymph from the thyroid gland will drain directly to which of the following nodes?

      Your Answer:

      Correct Answer: Deep lateral cervical lymph nodes

      Explanation:

      Lymphatic drainage of the thyroid gland involves the lower deep cervical, prelaryngeal, pretracheal, and paratracheal nodes. The paratracheal and lower deep cervical nodes, specifically, receive lymphatic drainage from the isthmus and the inferior lateral lobes. The superior portions of the thyroid gland drain into the superior pretracheal and cervical nodes.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 7 - The 'pump handle' movement of the thoracic wall describes which of the following movements:...

    Incorrect

    • The 'pump handle' movement of the thoracic wall describes which of the following movements:

      Your Answer:

      Correct Answer: The anterior ends of the ribs moving upwards and forwards

      Explanation:

      Because the anterior ends of the ribs are inferior to the posterior ends, when the ribs are elevated, the anterior end moves upwards and forwards, moving the sternum upwards and forwards in turn. This ‘pump handle’ upwards and forwards movement changes the anteroposterior (AP) dimension of the thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 8 - Which of the following is NOT an adverse effect associated with warfarin therapy:...

    Incorrect

    • Which of the following is NOT an adverse effect associated with warfarin therapy:

      Your Answer:

      Correct Answer: Neutropenia

      Explanation:

      Adverse effects of warfarin:
      The most common adverse effect of warfarin is bleeding

      Other common adverse effects of warfarin include nausea, vomiting, diarrhoea, jaundice, hepatic dysfunction, pancreatitis, pyrexia, alopecia, purpura, and rash

      Skin necrosis is a rare but serious adverse effect of warfarin; treatment with warfarin should be stopped if warfarin related skin necrosis is suspected

      Calciphylaxis is a rare, but a very serious condition that causes vascular calcification and cutaneous necrosis

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 9 - Metabolic hyperaemia harmonizes local blood flow with local O2 demand. If there is...

    Incorrect

    • Metabolic hyperaemia harmonizes local blood flow with local O2 demand. If there is an increase in metabolic rate, the production of vasoactive metabolites increases. These metabolites act locally on the surrounding arterioles, causes vasodilation and an increase blood supply.

      Which of these metabolites is the most potent vasodilator in skeletal muscle?

      Your Answer:

      Correct Answer: K +

      Explanation:

      Hyperaemia is the process where the body adjusts blood flow to meet the metabolic needs of different tissues in health and disease. Vasoactive mediators that take part in this process include K+, adenosine, CO2, H+, phosphates and H2O2. Although the mechanism is not clear, all these mediators likely contribute to some extent at different points.

      Specific organs are more sensitive to specific metabolites:
      K+ and adenosine are the most potent vasodilators in skeletal muscles

      CO2 and K+ are the most potent vasodilators in cerebral circulation.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      0
      Seconds
  • Question 10 - Which of the following is the most likely causative organism of acute epiglottitis...

    Incorrect

    • Which of the following is the most likely causative organism of acute epiglottitis in a 6 year old?

      Your Answer:

      Correct Answer: Streptococcus pneumoniae

      Explanation:

      Since the introduction of the HIB vaccine, most cases of acute epiglottitis are now caused by Streptococcus spp. The condition is now rare in children.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 11 - Regarding antimuscarinic antispasmodics, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding antimuscarinic antispasmodics, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: They are contraindicated in paralytic ileus.

      Explanation:

      Antimuscarinics are contraindicated in paralytic ileus. Antimuscarinics reduce intestinal motility by blocking muscarinic acetylcholine receptors and relaxing smooth muscle. Hyoscine butylbromide is advocated as a gastrointestinal antispasmodic, but it is poorly absorbed and thus has limited clinical utility. Antimuscarinics cause a reduction in bronchial secretions (they can be used to this effect in palliative patients). Antispasmodics are occasionally of value in treating abdominal cramp associated with diarrhoea but they should not be used for primary treatment. Antispasmodics should be avoided in young children with gastroenteritis because they are rarely effective and have troublesome side effects.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      0
      Seconds
  • Question 12 - A 50-year-old man, known hypertensive on amlodipine has been visiting his GP with...

    Incorrect

    • A 50-year-old man, known hypertensive on amlodipine has been visiting his GP with symptoms of headache, tiredness, and muscle weakness. His blood test today shows a low potassium level of 2.8 mmol/L, and a slightly raised sodium level at 147 mmol/L.

      What is the MOST LIKELY diagnosis?

      Your Answer:

      Correct Answer: Conn’s syndrome

      Explanation:

      When there are excessive levels of aldosterone independent of the renin-angiotensin aldosterone axis, primary hyperaldosteronism occurs. Secondary hyperaldosteronism occurs due to high renin levels.

      Causes of primary hyperaldosteronism include:
      Conn’s syndrome
      Adrenal hyperplasia
      Adrenal cancer
      Familial aldosteronism

      Causes of secondary hyperaldosteronism include:
      Renal vasoconstriction
      Oedematous disorders
      Drugs – diuretics
      Obstructive renal artery disease

      Although patients are usually asymptomatic, when clinical features are present, classically hyperaldosteronism presents with:
      Hypokalaemia
      Sodium levels can be normal or slightly raised
      Hypertension
      Metabolic alkalosis
      Less common, clinical features are:
      Lethargy
      Headaches
      Intermittent paraesthesia
      Polyuria and polydipsia
      Muscle weakness (from persistent hypokalaemia)
      Tetany and paralysis (rare)

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds
  • Question 13 - Which of the following is a primary action of calcitonin: ...

    Incorrect

    • Which of the following is a primary action of calcitonin:

      Your Answer:

      Correct Answer: Decreased bone resorption through inhibition of osteoclast activity

      Explanation:

      Calcitonin is a 32 amino acid polypeptide that is primarily synthesised and released by the parafollicular cells (C-cells) of the thyroid gland in response to rising or high levels of plasma Ca2+ions. Its primary role is to reduce the plasma calcium concentration, therefore opposing the effects of parathyroid hormone.
      Secretion of calcitonin is stimulated by:
      – Increased plasma calcium concentration
      – Gastrin
      – Pentagastrin
      – The main actions of calcitonin are:
      – Inhibition of osteoclastic activity (decreasing calcium and phosphate resorption from bone)
      – Stimulation of osteoblastic activity
      – Decreases renal calcium reabsorption
      – Decreases renal phosphate reabsorption

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 14 - Regarding apoptosis, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Apoptosis leads to cell swelling and eventual cell lysis.

      Explanation:

      Apoptosis is a controlled form of cell death in which no cellular contents are released from the dying cell, and thus no inflammatory reaction is seen. Apoptosis may occur physiologically or pathologically. Apoptosis may be induced in two main ways: by the engagement of surface death receptors e.g. TNF-alpha (extrinsic pathway) or through cellular injury (intrinsic pathway). The end result is the activation of proteases enzymes called caspases which dismantle the cell cytoplasm and nucleus. Apoptotic cells shrink down and fragment into apoptotic bodies, each of which retains an intact cell membrane; apoptotic bodies are then targeted or rapid removal by adjacent cells. Disordered apoptosis is thought to be central to a number of important disease processes, particularly carcinogenesis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      0
      Seconds
  • Question 15 - Which of the following nerves is responsible for the symptoms of a patient...

    Incorrect

    • Which of the following nerves is responsible for the symptoms of a patient with history of recurrent herpes simplex outbreaks on his face and presents with ophthalmic herpes zoster and a painful vesicle on the tip of his nose?

      Your Answer:

      Correct Answer: Nasociliary nerve

      Explanation:

      Hutchinson sign relates to involvement of the tip of the nose from facial herpes zoster. It implies involvement of the external nasal branch of the nasociliary nerve which is a branch of the ophthalmic division of the trigeminal nerve.

      The nasociliary branch of the trigeminal nerve innervates the apex and lateral aspect of the nose, as well as the cornea. Therefore, lesions on the side or tip of the nose should raise suspicion of ocular involvement.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 16 - A 35 year old patient presents to ED having sustained an injury to...

    Incorrect

    • A 35 year old patient presents to ED having sustained an injury to his right hand whilst playing cricket. He is unable to fully straighten his right middle finger as the distal phalanx remains flexed. Which of the following structures within the digit was most likely injured:

      Your Answer:

      Correct Answer: Insertion of terminal extensor digitorum tendon

      Explanation:

      Damage to the insertion of the terminal extensor digitorum tendon would result in loss of extension at the distal interphalangeal joint causing a fixed flexion deformity, called the Mallet deformity.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 17 - A 28-year-old female patient with a history of hypothyroidism arrives at the Emergency...

    Incorrect

    • A 28-year-old female patient with a history of hypothyroidism arrives at the Emergency Department after taking 30 of her 200 mcg levothyroxine tablets. She tells you she's 'tired of life' and 'can't take it any longer.' She is currently asymptomatic, and her findings are all within normal limits.

      What is the minimum amount of levothyroxine that must be taken before thyrotoxicosis symptoms appear?

      Your Answer:

      Correct Answer: >10 mg

      Explanation:

      An overdose of levothyroxine can happen by accident or on purpose. Intentional overdosing is sometimes done to lose weight, but it can also happen in patients who are suicidal. The development of thyrotoxicosis, which can lead to excited sympathetic activity and high metabolism syndrome, is the main source of concern. The time between ingestion and the emergence of clinical features associated with an overdose is often quite long.

      After a levothyroxine overdose, the majority of patients are asymptomatic. Symptoms and signs are usually only seen in patients who have taken more than 10 mg of levothyroxine in total.

      The following are the most commonly seen clinical features in patients developing clinical features:
      Tremor
      Agitation
      Sweating
      Insomnia
      Headache
      Increased body temperature
      Increased blood pressure
      Diarrhoea and vomiting
      Less common clinical features associated with levothyroxine overdose include:
      Seizures
      Acute psychosis
      Thyroid storm
      Tachycardia
      Arrhythmias
      Coma

      The continued absorption of the ingested levothyroxine causes a progressive rise in both total serum T4 and total serum T3 levels in the first 24 hours after an overdose. However, in some cases, the biochemical picture is completely normal. Thyroid function tests are not always recommended after a thyroxine overdose. Although elevated thyroxine levels are common, they have little clinical significance and have no impact on treatment. Following a levothyroxine overdose, the following biochemical features are common:
      T4 and T3 levels in the blood are elevated.
      Free T4 and Free T3 levels are higher.
      TSH levels in the blood are low.
      If the patient is cooperative and more than 10 mg of levothyroxine has been consumed, activated charcoal can be given (i.e., likely to become symptomatic)
      Within an hour of ingestion, the patient presents.

      The treatment is mostly supportive and aimed at managing the sympathomimetic symptoms that come with levothyroxine overdose. If beta blockers aren’t an option, try propranolol 10-40 mg PO 6 hours or diltiazem 60-180 mg 8 hours.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 18 - Regarding fluid balance, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding fluid balance, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: About three-quarters of extracellular fluid is interstitial.

      Explanation:

      An ‘average’ person (70 kg male) contains about 40 litres of water in total, separated into different fluid compartments by biological semipermeable membranes; plasma cell membranes between extracellular and intracellular fluid, and capillary walls between interstitial and intravascular fluid. Around two-thirds of the total fluid (27 L) is intracellular fluid (ICF) and one-third of this (13 L) is extracellular fluid (ECF). The ECF can be further divided into intravascular fluid (3.5 L) and interstitial fluid (9.5 L).
      Transcellular fluid refers to any fluid that does not contribute to any of the main compartments but which are derived from them e.g. gastrointestinal secretions and cerebrospinal fluid, and has a collective volume of approximately 2 L.
      Osmosis is the passive movement of water across a semipermeable membrane from regions of low solute concentration to those of higher solute concentration.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds
  • Question 19 - Which of the following is NOT a typical feature of a lesion to...

    Incorrect

    • Which of the following is NOT a typical feature of a lesion to the vestibulocochlear nerve:

      Your Answer:

      Correct Answer: Hyperacusis

      Explanation:

      Hyperacusis is increased acuity of hearing with hypersensitivity to low tones resulting from paralysis of the stapedius muscle, innervated by the facial nerve. General sensation to the face and to the anterior two-thirds of the tongue is carried by the divisions of the trigeminal nerve (although taste to the anterior two-thirds of the tongue is supplied by the facial nerve). Eye movements are mediated by the oculomotor, trochlear and abducens nerve. Ptosis results from paralysis of the levator palpebrae superioris, innervated by the oculomotor nerve, or the superior tarsal muscle, innervated by the sympathetic chain.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      0
      Seconds
  • Question 20 - You are examining the lower limbs of a 54 year old man who...

    Incorrect

    • You are examining the lower limbs of a 54 year old man who presented after falling from a ladder at home. During your neurological assessment you note a weakness of hip flexion. Which of the following nerves is the most important for flexion of the thigh at the hip joint:

      Your Answer:

      Correct Answer: Femoral nerve

      Explanation:

      Flexion of the thigh at the hip joint is produced by the sartorius, psoas major, iliacus and pectineus muscles, assisted by the rectus femoris muscle, all innervated by the femoral nerve (except for the psoas major, innervated by the anterior rami of L1 – 3).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 21 - Regarding thalassaemia, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

      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
      0
      Seconds
  • Question 22 - A 32 year old woman presents with episodes of flushing, headaches and palpitations....

    Incorrect

    • A 32 year old woman presents with episodes of flushing, headaches and palpitations. On examination her blood pressure is significantly elevated. Which of the following is the most likely diagnosis:

      Your Answer:

      Correct Answer: Pheochromocytoma

      Explanation:

      Phaeochromocytomas are catecholamine-secreting tumours which occur in about 0.1% of patients with hypertension. In about 90% of cases they arise from the adrenal medulla. The remaining 10%, which arise from extra-adrenal chromaffin tissue, are termed paragangliomas. Common presenting symptoms include one or more of headache, sweating, pallor and palpitations. Less commonly, patients describe anxiety, panic attacks and pyrexia. Hypertension, whether sustained or episodic, is present in at least 90% of patients. Left untreated phaeochromocytoma can occasionally lead to hypertensive crisis, encephalopathy, hyperglycaemia, pulmonary oedema, cardiac arrhythmias, or even death.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 23 - The most important nerve for plantar flexion of the foot at the ankle...

    Incorrect

    • The most important nerve for plantar flexion of the foot at the ankle joint is:

      Your Answer:

      Correct Answer: Tibial nerve

      Explanation:

      Muscles of the posterior compartment of the leg, innervated by the tibial nerve, perform plantar flexion of the foot at the ankle joint. The fibularis longus (innervated by the superficial fibular nerve) assists in plantar flexion but is not the most important.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
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  • Question 24 - A 15-year-old girl took 20 tablets of paracetamol almost 4 hours ago after...

    Incorrect

    • A 15-year-old girl took 20 tablets of paracetamol almost 4 hours ago after her mother for refused to provide her permission for her to go on a girl's trip. The girl is healthy and has no known comorbidities or drug history. Which one of the following is TRUE regarding paracetamol?

      Your Answer:

      Correct Answer: It is excreted renally

      Explanation:

      Acetaminophen is an acetanilide derivative and is a widely used non-prescription analgesic and antipyretic medication for mild-to-moderate pain and fever.

      The route of elimination: Paracetamol is metabolised extensively in the liver and excreted in the urine mainly as inactive glucuronide and sulfate conjugates, <5% is excreted as free (unconjugated) acetaminophen, and >90% of the dose administered is excreted within 24 hours.

      It is thought to work by selectively inhibiting COX-1 receptors in the brain and spinal cord: It is categorized by the FDA as an NSAID as it is believed to selectively inhibit cyclo-oxygenase 3 (COX-3) receptors in the brain and spinal cord.

      COX-3 is a unique variant of the more known COX-1 and COX-2. It is responsible for the production of prostaglandins in central areas, which sensitizes free nerve endings to the chemical mediators of pain. Therefore, by selectively inhibiting COX-3, paracetamol effectively reduces pain sensation by increasing the pain threshold.

      Toxicity is primarily due to glutathione production: Acetaminophen metabolism by the CYP2E1 pathway releases a toxic metabolite known as N-acetyl-p-benzoquinoneimine (NAPQI). NAPQI primarily contributes to the toxic effects of acetaminophen. NAPQI is an intermediate metabolite that is further metabolized by fast conjugation with glutathione. The conjugated metabolite is then excreted in the urine as mercapturic acid. High doses of acetaminophen (overdoses) can lead to hepatic necrosis due to depleting glutathione and high binding levels of reactive metabolite (NAPQI) to important parts of liver cells.

      Acetaminophen can be administered orally, rectally, or intravenously. It is predominantly metabolized in the liver, and the elimination half-life is 1-3 hours after a therapeutic dose. But maybe greater than 12 hours after an overdose.

      It is primarily metabolized via the cytochrome p450 enzyme system: It is predominantly metabolized in the liver by three main metabolic pathways:
      1. Glucuronidation (45-55%)
      2. Sulphate conjugation (30-35%)
      3. N-hydroxylation via the hepatic cytochrome p450 enzyme system (10-15%)

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
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  • Question 25 - Which of the following statements is correct regarding the lymphatic system? ...

    Incorrect

    • Which of the following statements is correct regarding the lymphatic system?

      Your Answer:

      Correct Answer: Lymphatic vessels contain both smooth muscle and unidirectional valves.

      Explanation:

      Fluid filtration out of the capillaries is usually slightly greater than fluid absorption into the capillaries. About 8 L of fluid per day is filtered by the microcirculation and returns to the circulation by the lymphatic system. Lymphatic capillaries drain into collecting lymphatics, then into larger lymphatic vessels. Both of these containing smooth muscle and unidirectional valves. From this point, lymph is propelled by smooth muscle constriction and vessel compression by body movements into afferent lymphatics. It then goes to the lymph nodes where phagocytes remove bacteria and foreign materials. It is here that most fluid is reabsorbed by capillaries, and the remainder returns to the subclavian veins via efferent lymphatics and the thoracic duct. The lymphatic system has a major role to play in the body’s immune defence and also has a very important role in the absorption and transportation of fats.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
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  • Question 26 - Clostridium tetani causes which of the following infectious diseases: ...

    Incorrect

    • Clostridium tetani causes which of the following infectious diseases:

      Your Answer:

      Correct Answer: Tetanus

      Explanation:

      Clostridium tetani causes tetanus.
      Scarlet fever is caused by Streptococcus pyogenes.
      Toxic shock syndrome is caused by Staphylococcus aureus or Streptococcus pyogenes.
      Gas gangrene is primarily caused by Clostridium perfringens.
      Pseudomembranous colitis is commonly caused by Clostridium difficile.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 27 - A patient was diagnosed with Erb's palsy as a result of a brachial...

    Incorrect

    • A patient was diagnosed with Erb's palsy as a result of a brachial plexus injury sustained in a car accident and, as a result, suffers from left arm paralysis. The following muscles are affected by the injury, except

      Your Answer:

      Correct Answer: Trapezius

      Explanation:

      Damage to the C5 and C6 nerve roots causes Erb’s palsy.

      The spinal accessory nerve (CN XI) innervates the trapezius muscle, thus you would not expect this muscle to be impacted.

      The trapezius is a muscle that runs from the base of the neck across the shoulders and into the centre of the back.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 28 - A 42-year-old woman with a history of hyposplenism arrives at the Emergency Department...

    Incorrect

    • A 42-year-old woman with a history of hyposplenism arrives at the Emergency Department sick and feverish. A complete set of bloods, including a peripheral blood film, is organised.

      On a hyposplenic blood film, which of the following features is LEAST likely to be seen?

      Your Answer:

      Correct Answer: Teardrop cells

      Explanation:

      The collection of abnormalities found in these patients is referred to as a hyposplenic film.
      The following features can be seen on hyposplenic blood films:
      Howell-Jolly bodies
      Heinz’s bodies
      Target cells
      RBCs with nuclei on occasion
      Lymphocytosis
      Macrocytosis
      Acanthocytes
      Teardrop cells, also known as dacrocytes, are named for their teardrop-shaped shape.

      Dacrocytosis is a condition in which a large number of these cells are present. Myelofibrosis and beta thalassemia major both have dacrocytes, but hyposplenism does not.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 29 - A 63 year old lady presents to ED with a persistent cough and...

    Incorrect

    • A 63 year old lady presents to ED with a persistent cough and red currant jelly sputum. She has a history of chronic alcohol abuse and has an X-ray which demonstrates a cavitating pneumonia. The most likely causative pathogen is:

      Your Answer:

      Correct Answer: Klebsiella pneumoniae

      Explanation:

      One of the results of Klebsiella pneumoniae is pneumonia that is usually a very severe infection. It is characterised by thick, bloody sputum (red currant jelly sputum), and is associated with complications like lung abscess, cavitation, necrosis, empyema and pleural effusions.

    • This question is part of the following fields:

      • Infections
      • Microbiology
      0
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  • Question 30 - A 33 year old female patient presents to emergency room with some symptoms...

    Incorrect

    • A 33 year old female patient presents to emergency room with some symptoms that she thinks might be due to a drug that she has recently started. She was started on hyoscine butyl bromide for symptomatic relief of irritable bowel syndrome. The least likely expected side effect of this drug in this patient is:

      Your Answer:

      Correct Answer: Diarrhoea

      Explanation:

      One of the commonest antispasmodic medications that is used is hyoscine butylbromide. It is an antimuscarinic and typical side effects of this class of drugs include:
      – dilation of pupils with loss of accommodation (cycloplegia)
      -photophobia resulting in blurred vision (Blind as a bat)
      -dry mouth, eyes and skin (Dry as a bone),
      -elevated temperature (Hot as a hare)
      -skin flushing (Red as a beet)
      -confusion or agitation particularly in the elderly (Mad as a hatter)
      -reduced bronchial secretions
      -transient bradycardia followed by tachycardia, palpitation and arrhythmias
      -urinary retention and/or constipation

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Immune Responses (0/1) 0%
Pathology (0/1) 0%
Passmed