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Question 1
Correct
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A 59-year-old man presents to the emergency room with chest pain. The cardiology team recently discharged him. He underwent a procedure and was given several medications, including abciximab, during his stay. Which of the following statements about abciximab is correct?
Your Answer: It is a glycoprotein IIa/IIIb receptor antagonist
Explanation:Abciximab (ReoPro) is a glycoprotein IIb/IIIa receptor antagonist that is a chimeric monoclonal antibody. It is primarily used during and after coronary artery procedures such as angioplasty to inhibit platelet aggregation.
It’s approved for use as a supplement to heparin and aspirin in high-risk patients undergoing percutaneous transluminal coronary intervention to prevent ischaemic complications. Only one dose of abciximab should be given (to avoid additional risk of thrombocytopenia).
Before using, it is recommended that baseline prothrombin time, activated clotting time, activated partial thromboplastin time, platelet count, haemoglobin, and haematocrit be measured. 12 and 24 hours after starting treatment, haemoglobin and haematocrit should be measured again, as should platelet count 2-4 hours and 24 hours after starting treatment.
When used for high-risk patients undergoing angioplasty, the EPIC trial(link is external)found that abciximab reduced the risk of death, myocardial infarction, repeat angioplasty, bypass surgery, and balloon pump insertion.The use of abciximab is contraindicated in the following situations:
Internal bleeding is present.
Within the last two months, you’ve had major surgery, intracranial surgery, or trauma.
Stroke in the previous two years
Intracranial tumour
Aneurysm or arteriovenous malformation
Haemorrhagic diathesis is a type of haemorrhagic diathesis.
Vasculitis
Retinopathy caused by hypertensionThe following are some of the most common abciximab side effects:
Manifestations of bleeding
Bradycardia
Back ache
Pain in the chest
Vomiting and nausea
Pain at the puncture site
Thrombocytopenia -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 2
Correct
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Which of the following side effects is most likely caused by erythromycin:
Your Answer: QT - prolongation
Explanation:The side effects of erythromycin include abdominal pain, anaphylaxis,
cholestatic hepatitis, confusion,
diarrhoea, dyspepsia, fever, flatulence, hallucinations, hearing loss,
headache, hypertrophic pyloric stenosis, hypotension, Interstitial
nephritis, mild allergic reactions, nausea, nervous system effects,
including seizures, pain, pruritus, pseudomembranous colitis,
QT prolongation, rash, skin eruptions, tinnitus, urticaria,
ventricular arrhythmias, ventricular tachycardia, vertigo, vomiting -
This question is part of the following fields:
- Infections
- Pharmacology
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Question 3
Correct
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A 35-year-old man, who was feeling unwell after his return from a business trip, was diagnosed with a disease that is known to be transmitted by a vector.
Among the following microorganisms, which of the following has a mode of transmission of being vector-borne?Your Answer: Plasmodium falciparum
Explanation:Plasmodium falciparum is a parasite that is vector-borne which is transmitted by the female Anopheles mosquito.
Bordetella pertussis is transmitted through the respiratory tract, via respiratory droplets or direct contact with infectious secretions.
Mycobacterium tuberculosis is transmitted via inhalation of infected respiratory droplets.
HIV may be transmitted via sexual contact, vertical transmission from mothers to infants, and among injection drug users sharing infected needles, as well as through transfusion of infected blood products.
Treponema pallidum transmission normally occurs during direct sexual contact with an individual who has an active primary or secondary syphilitic lesion.
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This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 4
Correct
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Which of the following is the most common cause of hyperthyroidism:
Your 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.
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This question is part of the following fields:
- Endocrine
- Physiology
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Question 5
Correct
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Regarding threadworms, which of the following statements is CORRECT:
Your Answer: First line treatment of threadworms is with mebendazole.
Explanation:First line treatment of threadworms is with mebendazole, with treatment of the whole family, and a repeat treatment after 2 weeks. Threadworms live in the large bowel, but direct multiplication of worms does not occur here. Threadworms most commonly infect children, and may be symptomatic or cause pruritus ani.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 6
Correct
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An very unwell patient is receiving treatment in your hospital's HDU and is found to have an Escherichia coli O157 infection.
Which one of these statements about Escherichia coli O157 is true?Your Answer: Haemolytic uraemic syndrome develops in approximately 6% of patients
Explanation:Escherichia coli O157 is a serotype of Escherichia coli.
The Escherichia coliO157 strain is ‘enterohaemorrhagic’ and causes severe forms of acute haemorrhagic diarrhoea. It can also cause non-haemorrhagic diarrhoea.Incubation period of Escherichia coli O157 is usually 3-4 days and bloody diarrhoea usually begins on the 3rd or 4th day of the infection.
Infections with Escherichia coliO157 are more common during the warmer months than in winter.
Haemolytic uraemic syndrome develops in approximately 6% of patients. It is commonly seen in children and in the elderly.
Escherichia coli O157 can also cause:
Haemorrhagic colitis
Haemolytic uraemic syndrome
Thrombotic thrombocytopenic purpura but not immune thrombocytopenic purpura. -
This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 7
Incorrect
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An 82 year old man taking warfarin as a maintenance medication comes in to your clinic because of an infection. Which antibiotic is the safest choice for this patient?
Your Answer: Ciprofloxacin
Correct Answer: Cefalexin
Explanation:Alterations in the international normalized ratio (INR) brought about by the concurrent use of antibiotics and warfarin may result in either excessive clotting or excessive bleeding if they are deemed to have a high risk for interaction. As such, there should be careful consideration of the class of antibiotic to be used.
Antibiotics from the following drug classes should generally be avoided as they have a high risk for interaction with warfarin, possible enhancing the anticoagulant effects of warfarin resulting in bleeding: Fluoroquinolones (e.g. ciprofloxacin, levofloxacin), Macrolides (e.g. clarithromycin, erythromycin, azithromycin), Nitroimidazoles (e.g. metronidazole), Sulphonamides (e.g. co-trimoxazole, a combination of trimethoprim and sulfamethoxazole), Trimethoprim, Tetracyclines (e.g. doxycycline).
Low risk antibiotics that have low risk for interaction with warfarin includes cephalexin, from the cephalosporin class, and clindamycin which is a lincomycin.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 8
Correct
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Which of the following statements is correct regarding hyponatraemia?
Your Answer: Correction of serum sodium that is too rapid can precipitate central pontine myelinolysis.
Explanation:Hyponatraemia refers to a serum sodium concentration < 135 mmol/L.
It is safer to quickly correct acute hyponatremia than chronic hyponatremia but correction should not be too fast, especially in chronic hyponatraemia, because of the risk of central pontine myelinolysis. Hyponatraemia is usually associated with a low plasma osmolality.
Under normal circumstances, if serum osmolality is low, then urine osmolality should also be low because the kidneys should be trying to retain solute.
In SIADH, excess ADH causes water retention, but not the retention of solute. Therefore, urine that is concentrated and relatively high in sodium is produced, even though the serum sodium is low (urine osmolality > 100 mosmol/kg). -
This question is part of the following fields:
- Endocrine
- Physiology
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Question 9
Incorrect
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Through which of the following anatomical structures does an indirect inguinal hernia pass?
Your Answer: Transverse abdominis
Correct Answer: External oblique
Explanation:Inguinal hernias are subdivided into direct and indirect.
An indirect hernia occurs when abdominal contents protrude through the internal inguinal ring and into the inguinal canal. This occurs lateral to the inferior epigastric vessels. The hernia contents may extend into the scrotum.
A direct inguinal hernia is protrusion of abdominal contents through the transversalis fascia within Hesselbach’s triangle. The borders of Hesselbach’s triangle are the inferior epigastric vessels superolaterally, the rectus sheath medially, and inguinal ligament inferiorly.
The deep (internal) inguinal ring is located above and halfway between the pubic tubercle and the anterior superior iliac spine. This serves as the entrance to the inguinal canal. The superficial (external) inguinal ring lies immediately above and medial to the pubic tubercle. This triangular opening is a defect in the external oblique aponeurosis, and forms the exit of the inguinal canal.
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This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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Question 10
Incorrect
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A dermatological examination of a patient who has presented with a lump shows a collection of boils clustered together.
Which one of these best describes the lump you have found on examination?Your Answer: Furuncle
Correct Answer: Carbuncle
Explanation:A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus.
A carbuncle is a collection of individual boils clustered together.
A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter.
A vesicle is a visible collection of clear fluid measuring less than 0.5 cm in diameter.
A pustule is a small visible skin elevation containing an accumulation of pus.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 11
Incorrect
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Parathyroid hormone is released by which of the following:
Your Answer: Parafollicular cells of the thyroid gland
Correct Answer: Chief cells of the parathyroid gland
Explanation:Parathyroid hormone (PTH) is a peptide hormone synthesised by the chief cells of the parathyroid glands, located immediately behind the thyroid gland. PTH is primarily released in response to decreasing plasma [Ca2+] concentration. PTH acts to increase plasma calcium levels and decrease plasma phosphate levels.
Parathyroid hormone (PTH) acts to increase calcium reabsorption in the distal tubule of the nephron (by activating Ca2+entry channels in the apical membrane and the Ca2+ATPase pump in the basolateral membrane) and increase phosphate excretion by inhibiting reabsorption in the proximal tubule of the nephron. -
This question is part of the following fields:
- Endocrine
- Physiology
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Question 12
Incorrect
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Which of the following clinical features is NOT typical of a facial nerve palsy:
Your Answer: Hyperacusis
Correct Answer: Inability to raise the eyelid
Explanation:Facial nerve palsy can result in inability to close the eye due to paralysis of the orbicularis oculi muscle. Elevation of the eyelid in eye opening is a function of the levator palpebrae superioris muscle and the superior tarsal muscle, innervated by the oculomotor nerve and the sympathetic chain respectively.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 13
Incorrect
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The following statements are not true of the extensor carpi radialis brevis muscle, except?
Your Answer: It is innervated by the posterior interosseous nerve
Correct Answer: It receives its blood supply from the radial artery
Explanation:Extensor carpi radialis brevis is a fusiform muscle found in the lateral part of the posterior forearm. Together with anconaeus, brachioradialis, extensor carpi radialis longus, extensor digitorum, extensor digiti minimi and extensor carpi ulnaris, it belongs to the superficial forearm extensor group. Extensor carpi radialis brevis originates from the lateral epicondyle of humerus via the common extensor tendon. This is a common origin that it shares with the extensor digitorum, extensor digiti minimi and extensor carpi ulnaris muscles. Some fibres also originate from the lateral intermuscular septum, a thick aponeurosis that covers the muscle itself, and from the radial collateral ligament.
The muscle courses inferiorly, giving off a long tendon in the middle of the forearm which descends towards the dorsal hand. The tendon passes through a groove on the posterior surface of radius, deep to the extensor retinaculum. After traversing the extensor retinaculum space, the tendon inserts into the posterior aspect of the base of the third metacarpal bone.
Extensor carpi radialis brevis is innervated directly by the radial nerve (C5- C8), or sometimes from its deep branch/posterior interosseous nerve. The radial nerve stems from the posterior cord of the brachial plexus.
The muscle is vascularized by the radial recurrent artery, radial artery and deep brachial artery (via its radial collateral branch).
Extensor carpi radialis brevis works together with extensor carpi ulnaris and extensor carpi radialis longus to extend the hand at the wrist joint. This action is vital in a sequence of muscle contractions needed for clenching a fist or making a grip. When performing these functions, wrist extension blocks the flexor muscles from on acting upon the hand. Instead, flexors act only on the digits, thereby flexing them and producing an effective hand grip, such as that seen in a tennis backhand. When the extensor carpi radialis brevis muscle contracts together with extensor carpi radialis longus and flexor carpi radialis, it contributes to producing hand abduction (radial deviation).
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 14
Incorrect
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A patient is referred to the Medicine Department for complaints of unilateral hearing loss, tinnitus and facial numbness. Upon further investigation, an acoustic neuroma is given as the final diagnosis.
Which of the following nerves is least likely to be affected in acoustic neuroma?Your Answer:
Correct Answer: Trochlear nerve
Explanation:Acoustic neuroma is also called vestibular schwannoma (VS), acoustic neuroma, vestibular neuroma or acoustic neurofibroma. These are tumours that evolve from the Schwann cell sheath and can be either intracranial or extra-axial. They usually occur adjacent to the cochlear and vestibular nerves and most often arise from the inferior division of the latter. Anatomically, acoustic neuroma tends to occupy the cerebellopontine angle. About 5-10% of cerebellopontine angle (CPA) tumours are meningiomas and may occur elsewhere in the brain. Bilateral acoustic neuromas tend to be exclusively found in individuals with type 2 neurofibromatosis.
The following nerves may be affected due to nerve compression:
Facial nerve: usually minimal with late presentation except for very large tumours. Depending on the degree of engagement of the nerve, the symptoms may include twitching, increased lacrimation and facial weakness.
Trigeminal Nerve: paraesthesia in the trigeminal distribution, tingling of the tongue, impairment of the corneal reflex, and less commonly pain which may mimic typical trigeminal neuralgia.
Glossopharyngeal and Vagus nerves: palatal paresis, hoarseness of voice and dysphagia
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 15
Incorrect
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Since the fluid that enters the loop of Henle is isotonic, what is its estimated osmolality?
Your Answer:
Correct Answer: 300 mOsm
Explanation:The loop of Henle connects the proximal tubule to the distal convoluted tubule and lies parallel to the collecting ducts. It is consists of three major segments, the thin descending limb, the thin ascending limb, and the thick ascending limb.
The segments are differentiated based on structure, anatomic location, and function. The main action of the loop of Henle is to recover water and sodium chloride from urine. The liquid entering the loop of Henle is a solution of salt, urea, and other substances traversed along by the proximal convoluted tubule, from which most of the dissolved components are needed by the body, particularly glucose, amino acids, and sodium bicarbonate that have been reabsorbed into the blood.
This fluid is isotonic. Isotonic fluids generally have an osmolality ranging from 270 to 310 mOsm/L. With the fluid that enters the loop of Henle, it is estimated to be 300 mOsm/L. However, after passing the loop, fluid entering the distal tubule is hypotonic to plasma since it has been diluted during its passage.
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This question is part of the following fields:
- Physiology
- Renal Physiology
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Question 16
Incorrect
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Regarding the hard palate, which of the following statements is CORRECT:
Your Answer:
Correct Answer: Lymphatic vessels from the palate usually drain into deep cervical lymph nodes.
Explanation:Lymphatic vessels from the pharynx and palate drain into the deep cervical lymph nodes.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 17
Incorrect
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A 57-year-old woman has presented with cough and shortness of breath. Her GP had done some blood tests recently and told her that she had a positive ANA result.
Which of these statements is true about anti-nuclear antibodies (ANAs)? Select only ONE answer.
Your Answer:
Correct Answer: The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome
Explanation:Anti-nuclear antibodies are auto-antibodies directed against a variety of nuclear antigens. There are different staining patterns and each pattern is suggestive of a different disorder.
Speckled staining is suggestive of mixed connective tissue disease.
Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.
Anti-double stranded DNA is suggestive of SLE while anti-histone antibodies are suggestive of drug-induced lupus.
ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most accurate.
The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome. Felty’s syndrome is characterized by a combination of rheumatoid arthritis, splenomegaly and neutropenia.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 18
Incorrect
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Which segment of the colon is most likely to be affected in diverticulitis?
Your Answer:
Correct Answer: Sigmoid colon
Explanation:Diverticulitis refers to inflammation and infection associated with a diverticulum and is estimated to occur in 10% to 25% of people with diverticulosis. Peridiverticular and pericolic infection results from a perforation (either macroscopic or microscopic) of a diverticulum, which leads to contamination, inflammation, and infection. The spectrum of disease ranges from mild, uncomplicated diverticulitis that can be treated in the outpatient setting, to free perforation and diffuse peritonitis that requires emergency laparotomy. Most patients present with left sided abdominal pain, with or without fever, and leucocytosis. The most common location for diverticulitis is the sigmoid colon.
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This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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Question 19
Incorrect
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Which of the following laboratory findings are suggestive of functional hyposplenism:
Your Answer:
Correct Answer: Howell-Jolly bodies
Explanation:Functional hyposplenism is characterised by the blood film findings of Howell-Jolly bodies or siderotic granules on iron staining. The most frequent cause is surgical removal of the spleen e.g. after traumatic rupture, but hyposplenism can also occur in sickle cell anaemia, gluten-induced enteropathy, amyloidosis and other conditions.
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 20
Incorrect
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A 45-old woman is on several medications and being treated for epilepsy and bipolar disorder. In the ward rounds, you are asked to examine her in detail and discover she has a noticeable tremor. You believe that one of her medications may be responsible for this new onset tremor.
Which of the following medications is least likely to be responsible for this tremor?Your Answer:
Correct Answer: Carbamazepine
Explanation:The only medication that does not commonly cause tremors is carbamazepine.
The other drugs present with the following types of tremors as a side effect to their usage:
1. Sodium valproate – Postural tremor is most common, but a resting tremor can also occur. Approximately 25% of patients taking sodium valproate are found to develop a tremor within 12 months of starting therapy.
2. Lithium – fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer.
3. Atypical antipsychotics, such as olanzapine and quetiapine – tremor and limb shakiness. -
This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 21
Incorrect
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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:
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 saltsCurrent 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
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Question 22
Incorrect
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A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense, vibratory sense, and discriminatory touch. Upon further physical examination, it was observed that her tongue deviates to the left-hand side. An MRI and CT scan was ordered and results showed that he was suffering a left-sided stroke.
Which of the following is considered the best diagnosis for the case presented above?Your Answer:
Correct Answer: Medial medullary syndrome
Explanation:Medial medullary syndrome is a form of stroke that affects the medial medulla of the brain. It is caused by a lesion in the medial part of the medulla, which is due to an infraction of vertebral arteries and/or paramedian branches of the anterior spinal artery.
It is characterized by contralateral paralysis of the upper and lower limb of the body, a contralateral decrease in proprioception, vibration, and/or fine touch sensation, paresthesias or less commonly dysesthesias in the contralateral trunk and lower limb, and loss of position and vibration sense with proprioceptive dysfunction. Ipsilateral deviation of the tongue due to ipsilateral hypoglossal nerve damage can also be seen.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 23
Incorrect
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Which of the following is NOT a typical clinical feature of beta-thalassaemia major:
Your Answer:
Correct Answer: Increased bleeding tendency
Explanation:Features include:
– severe anaemia (becoming apparent at 3 – 6 months when the switch from gamma-chain to beta-chain production takes place)
– failure to thrive
– hepatosplenomegaly (due to excessive red cell destruction, extramedullary haemopoiesis and later due to transfusion related iron overload)
– expansion of bones (due to marrow hyperplasia, resulting in bossing of the skull and cortical thinning with tendency to fracture)
– increased susceptibility to infections (due to anaemia, iron overload, transfusion and splenectomy)
– osteoporosis
– hyperbilirubinaemia and gallstones
– hyperuricaemia and gout
– other features of haemolytic anaemia
– liver damage and other features of iron overload -
This question is part of the following fields:
- Haematology
- Pathology
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Question 24
Incorrect
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The least likely feature of anaemia is:
Your Answer:
Correct Answer: Narrow pulse pressure
Explanation:Non-specific signs of anaemia include:
1. pallor of mucous membranes or nail beds (if Hb < 90 g/L),
2. tachycardia
3. bounding pulse
4. wide pulse pressure
5. flow murmurs
6. cardiomegaly
7. signs of congestive cardiac failure (in severe cases) -
This question is part of the following fields:
- Haematology
- Pathology
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Question 25
Incorrect
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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
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Question 26
Incorrect
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The role of the juxtaglomerular (granular) cells of the juxtaglomerular apparatus is:
Your Answer:
Correct Answer: Production of renin
Explanation:Juxtaglomerular cells synthesise renin. These cells are specialised smooth muscle cells that are located in the walls of the afferent arterioles, and there are some in the efferent arterioles.
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This question is part of the following fields:
- Physiology
- Renal
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Question 27
Incorrect
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After a work-related accident, a 33-year old male is taken to the emergency room with difficulty in adduction and flexion of his left arm at the glenohumeral joint. The attending physician is suspects involvement of the coracobrachialis muscle.
The nerve injured in the case above is?Your Answer:
Correct Answer: The musculocutaneous nerve
Explanation:The coracobrachialis muscle is innervated by the musculocutaneous nerve (C5-C7) a branch of the lateral cord of the brachial plexus.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 28
Incorrect
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A 24-year-old patient is suspected to have a possible acute hepatitis B infection and is currently under investigation.
Which of the following markers is considered the earliest indicator of acute infection in acute Hepatitis B?Your Answer:
Correct Answer: Hepatitis B surface Ag
Explanation:HBsAg is the serological hallmark of HBV infection. After an acute exposure to HBV, HBsAg appears in serum within 1 to 10 weeks. Persistence of this marker for more than 6 months implies chronic HBV infection.
Anti-HBs is known as a neutralizing antibody, and confers long-term immunity. In patients with acquired immunity through vaccination, anti-HBs is the only serological marker detected in serum.
HBcAg is an intracellular presence in infected hepatocyte, thus it is not identified in the serum. During acute infection, anti-HBc IgM and IgG emerges 1–2 weeks after the presence of HBsAg along with raised serum aminotransferase and symptoms. After 6 months of acute infection, anti-HBc IgM wears off. Anti-HBc IgG continues to detect in both patients with resolved HBV infection and chronic hepatitis B.
Hepatitis D virus, also known as the delta hepatitis virus, is a defective ssRNA virus that requires HBV for replication. The infection can occur in one of two clinical forms, co-infection or superinfection. In a co-infection, the patient is simultaneously infected with HBV and HDV. In a superinfection, an HDV infection develops in a patient with a chronic HBV infection.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 29
Incorrect
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You are asked to review the blood results on a 56-year-old man who appears to be acutely unwell. His results show that he is neutropenic.
Which ONE of the following is NOT a recognized cause of a neutropenia?Your Answer:
Correct Answer: Hyposplenism
Explanation:Neutropenia is defined as a total neutrophil count of < 2.0 x 109/l.
It can be caused by:
Viral infections
Collagen disease e.g. SLE and RA
Chemotherapy and radiotherapy
Hypersplenism
Marrow infiltration
Vitamin and folate deficiency
Drug reactions
Drugs that cause neutropenia include flecainide, phenytoin, carbimazole, indomethacin and co-trimoxazole. -
This question is part of the following fields:
- Haematology
- Pathology
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Question 30
Incorrect
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Which of the following is NOT a common side effect of adenosine:
Your Answer:
Correct Answer: Yellow vision
Explanation:Common side effects of adenosine include:
Apprehension
Dizziness, flushing, headache, nausea, dyspnoea
Angina (discontinue)
AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur) -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
