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  • Question 1 - Which of the following statements about neutrophils is TRUE: ...

    Incorrect

    • Which of the following statements about neutrophils is TRUE:

      Your Answer: Neutrophils comprise about 30% of circulating white cells.

      Correct 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
      83.9
      Seconds

  • Question 2 - As part of his angina treatment, a 68-year-old man is prescribed a beta...

    Incorrect

    • As part of his angina treatment, a 68-year-old man is prescribed a beta blocker. He starts having nightmares and has trouble sleeping soon after starting the beta-blocker.

      Which of the beta blockers listed below is the most likely to be in his system?

      Your Answer: Sotalol

      Correct Answer: Propranolol

      Explanation:

      The beta-adrenoceptors in the heart, peripheral vasculature, bronchi, pancreas, and liver are blocked by beta-adrenoceptor blocking drugs (beta blockers).

      Beta blockers come in a wide range of strengths, with the choice largely determined by the disease being treated and the patient’s unique circumstances. The intrinsic sympathomimetic activity, lipid solubility, duration of action, and cardioselectivity of beta blockers all differ.

      Some beta blockers are lipid (lipophilic) soluble, while others are water soluble (hydrophilic). Drugs that are more lipid-soluble are absorbed faster from the gut, undergo more first-pass metabolism, and are eliminated faster. They’re also more likely to get into the brain and cause central effects like insomnia and nightmares. Propranolol, pindolol, labetalol, and metoprolol are examples of lipid-soluble beta blockers. Beta blockers that are water-soluble are less likely to enter the brain and are more resistant to first-pass metabolism. They are excreted by the kidneys, and in renal impairment, dosage reduction is frequently required. Atenolol, nadolol, celiprolol, and sotalol are examples of water-soluble beta blockers.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      63.5
      Seconds

  • Question 3 - Which of the following immunoglobulins is predominant in saliva: ...

    Correct

    • Which of the following immunoglobulins is predominant in saliva:

      Your Answer: IgA

      Explanation:

      Immunoglobulin A is predominant in saliva.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      5.9
      Seconds

  • Question 4 - A 62-year-old woman presents with a 3-month history of lethargy and tiredness. She...

    Correct

    • A 62-year-old woman presents with a 3-month history of lethargy and tiredness. She states that she has also felt very itchy, particularly after a hot bath and that she is often dizzy and sweaty. On examination she appears plethoric and you note the presence of splenomegaly. Her blood tests today show that her haemoglobin level is 16.9 g/dl.
      What is the most likely diagnosis in this case? Select ONE answer only.

      Your Answer: Polycythaemia vera

      Explanation:

      Polycythaemia vera (PCV), which is also referred to as polycythaemia rubra vera, is a clonal haematological malignancy in which the bone marrow produces too many red blood cells. It may also result in the overproduction of white blood cells and platelets. It is most commonly seen in the elderly and the mean age at diagnosis is 65-74 years.
      Patients can be completely asymptomatic and it is often discovered as an incidental finding on a routine blood count. Approximately 1/3 of patients present with symptoms due to thrombosis, of these 3/4 have arterial thrombosis and 1/4 venous thrombosis. Features include stroke, myocardial infarction, deep vein thrombosis and pulmonary embolism.
      The other clinical features of PCV include:
      Plethoric appearance
      Lethargy and tiredness
      Splenomegaly (common)
      Pruritis (in 40% – particularly after exposure to hot water)
      Headaches, dizziness and sweating (in 30%)
      Gouty arthritis (in 20%)
      Budd-Chiari syndrome (in 5-10%)
      Erythromyalgia (in <5% – burning pain and red/blue discolouration of hands and feet)
      Increased incidence of peptic ulcer disease (possibly related to increased histamine release from mast cells)
      The diagnosis of PCV requires two major criteria and one minor criterion, or the first major criterion and two minor criteria:
      Major criteria:
      HB > 18.5 g/dl in men, 16.5 g/dl in women
      Elevated red cell mass > 25% above mean normal predicted value
      Presence of JAK2 mutation

      Minor criteria:
      Bone marrow biopsy showing hypercellularity with prominent erythroid, granulocytic and megakaryocytic proliferation
      Serum erythropoietin level below normal range
      Endogenous erythroid colony formation in vitro
      The main aim of treatment is to normalize the full blood count and prevent complications such as thrombosis. Venesection is the treatment of choice but hydroxyurea can also be used to help control thrombocytosis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      167.9
      Seconds

  • Question 5 - A patient who shows symptoms of infection and is admitted under supervision of...

    Incorrect

    • A patient who shows symptoms of infection and is admitted under supervision of the medical team. The organism which caused this, is a Gram-negative bacterium, according to the culture. A penicillin therapy is suggested by the microbiologist.

      Which of the penicillins listed below is the most effective against Gram-negative bacteria?

      Your Answer: Benzathine benzylpenicillin

      Correct Answer: Amoxicillin

      Explanation:

      Amoxicillin and Ampicillin are more hydrophilic (broad-spectrum) penicillins than benzylpenicillin and phenoxymethylpenicillin. Because they may penetrate through gaps in the outer phospholipid membrane, they are effective against Gram-negative bacteria. Amoxicillin and Ampicillin are resistant to penicillinase-producing microbes.

      Community-acquired pneumonia, otitis media, sinusitis, oral infections, and urinary tract infections are among the most prevalent conditions for which they are prescribed. The normal adult oral dose of Amoxicillin is 500 mg three times/day, which can be increased to 1 g three times/day if necessary. Ampicillin is given to adults in doses of 0.5-1 g every 6 hours.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      61.7
      Seconds

  • Question 6 - All these structures make up the portal triad EXCEPT? ...

    Correct

    • All these structures make up the portal triad EXCEPT?

      Your Answer: Branches of the hepatic vein

      Explanation:

      The portal triad, is made up of a portal arteriole (a branch of the hepatic artery), a portal venule (a branch of the hepatic portal vein) and a bile duct. Also contained within the portal triad are lymphatic vessels and vagal parasympathetic nerve fibres.

      Branches of the hepatic vein is not part of the portal triad

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      16.7
      Seconds

  • Question 7 - Which of the following cell types in the stomach secretes histamine? ...

    Correct

    • Which of the following cell types in the stomach secretes histamine?

      Your Answer: Enterochromaffin-like cells

      Explanation:

      The parietal cells operate in close association with another type of cell called enterochromaffin-like cells (ECL cells), the primary function of which is to secrete histamine. The ECL cells lie in the deep recesses of the oxyntic glands and therefore release histamine indirect contact with the parietal cells of the glands.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      11.2
      Seconds

  • Question 8 - A patient is referred for lung function tests on account of a history...

    Incorrect

    • A patient is referred for lung function tests on account of a history of breathlessness and cough.

      Which statement about lung volumes is correct?

      Your Answer: The vital capacity is the volume of air drawn in and out of the lungs during normal breathing

      Correct Answer: The tidal volume is the volume of air drawn in and out of the lungs during normal breathing

      Explanation:

      The tidal volume(TV) is the amount of air that moves in and out of the lungs with each respiratory cycle. In a healthy male, the usual volume is 0.5 L (,7 ml/kg body mass).

      The vital capacity(VC) is the maximum amount of air that can be exhaled following maximal inspiration. The usual volume in a healthy male is 4.5 L.

      The residual volume(RV) is the amount of air remaining in the lungs after maximum expiration. The usual volume in a healthy male is 1.0 L.

      The inspiratory reserve volume(IRV) is the maximum amount of air that can be breathed in forcibly after normal inspiration. The usual volume in a healthy male is 3.0 L.

      The expiratory reserve volume(ERV) is the volume of air that can be breathed out forcibly after normal expiration. The usual volume in a healthy male is 1.0 L.

      Total lung capacity(TLC) is the volume of air the lungs can accommodate. TLC = RV+VC. The usual volume in a healthy male is 5.5 L.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      1015
      Seconds

  • Question 9 - The most common cause of anaemia worldwide is which of the following? ...

    Correct

    • The most common cause of anaemia worldwide is which of the following?

      Your Answer: Iron deficiency anaemia

      Explanation:

      The most common cause of microcytic anaemia and of any anaemia worldwide is iron deficiency anaemia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      6.5
      Seconds

  • Question 10 - Regarding red blood cell group antigens and antibodies, which of the following statements...

    Incorrect

    • Regarding red blood cell group antigens and antibodies, which of the following statements is CORRECT:

      Your Answer: Naturally occurring anti-D antibodies occur in the plasma of all subjects who lack the RhD antigen.

      Correct Answer: Anti-D antibodies are usually IgG.

      Explanation:

      Approximately 400 red blood cell group antigens have been described. The ABO group antigens are unusual in that naturally occurring antibodies occur in the plasma of subjects who lack the corresponding antigen, even if they have not been exposed to that antigen previously. The most important of these natural antibodies are anti-A and anti-B, which are usually IgM. Anti-D antibodies don’t occur naturally, and are therefore immune antibodies that result from previous transfusions or pregnancy. Only IgG antibodies are capable of transplacental passage and the most important immune antibody is the Rh antibody, anti-D.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      127.3
      Seconds

  • Question 11 - Clostridium tetani causes which of the following infectious diseases: ...

    Correct

    • Clostridium tetani causes which of the following infectious diseases:

      Your 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
      8.3
      Seconds

  • Question 12 - Which cervical interspace is most likely injured if a patient presents with difficulty...

    Correct

    • Which cervical interspace is most likely injured if a patient presents with difficulty of shoulder abduction and elbow flexion, pain in the right shoulder and lateral arm, and decreased sensation over the deltoid and lateral arm?

      Your Answer: C4-C5

      Explanation:

      In the setting of cervical radiculopathy, because the nerve root of a spinal nerve is compressed or otherwise impaired, the pain and symptomatology can spread far from the neck and radiates to arm, neck, chest, upper back and/or shoulders. Often muscle weakness and impaired deep tendon reflexes are noted along the course of the spinal nerve.

      Cervical radiculopathy is almost always unilateral, although, in rare cases, both nerves at a given level may be impacted. Those rare presentations can confound physical diagnosis and require acceleration to advanced imaging especially in cases of trauma. If there is nerve impingement, the affected side will be reduced relative to the unaffected side. Reduction in strength of muscles innervated by the affected nerve is also significant physical finding.

      For a C4-C5 injury, the following symptoms may present:

      Weakness in the deltoid muscle (front and side of the shoulder) and upper arm
      Shoulder pain
      Numbness along the outside of the upper arm

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      25
      Seconds

  • Question 13 - A young female was diagnosed with a urinary tract infection and was sent...

    Incorrect

    • A young female was diagnosed with a urinary tract infection and was sent home with medications. However, after 48 hours of discharge, she returned to the hospital because there had been no relief from her symptoms. The urine sensitivity test report is still unavailable. Fresh blood tests were sent, and her estimated GFR is calculated to be >60 ml/minute.

      She was prescribed nitrofurantoin 100 mg modified-release orally twice a day for two days.

      Out of the following, which antibiotic is most appropriate to be prescribed to this patient?

      Your Answer: Ciprofloxacin

      Correct Answer: Fosfomycin

      Explanation:

      The NICE guidelines for women with lower UTIs who are not pregnant are:
      1. Consider prescribing a different antibiotic if symptoms do not improve within 48 hours or worsen at any time
      2. If the urine culture and susceptibility test results are available, review the choice of antibiotic according to the results and change the antibiotic accordingly if symptoms are not improving or bacteria is resistant to the prescribed antibiotic

      The first choice of antibiotics for non-pregnant women aged 16 years and over is:
      1. Nitrofurantoin
      100 mg modified-release PO BD for 3 days – if eGFR >45 ml/minute
      2. Trimethoprim
      200 mg PO BD for three days

      The second-choice (no improvement in lower UTI symptoms on first-choice for at least 48 hours, or when first-choice is not suitable) are:
      1. Nitrofurantoin
      100 mg modified-release PO BD for three days – if eGFR >45 ml/minute
      2. Pivmecillinam
      400 mg PO initial dose, then 200 mg PO TDS for three days
      3. Fosfomycin 3 g single sachet dose

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      36.5
      Seconds

  • Question 14 - Which of the following muscles is most responsible for thigh extension at the...

    Correct

    • Which of the following muscles is most responsible for thigh extension at the hip joint?

      Your Answer: Hamstrings and gluteus maximus

      Explanation:

      For hip extension, the gluteus maximus and hamstring muscles work together. To compensate for gluteus maximus weakness, the hamstring frequently acts as the primary hip extensor.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      35.4
      Seconds

  • Question 15 - Which of the following bacteria is a rod-shaped, oxidase-positive, opportunistic gram-negative bacteria that...

    Incorrect

    • Which of the following bacteria is a rod-shaped, oxidase-positive, opportunistic gram-negative bacteria that can cause a catheter-related urinary tract infection (UTI)?

      Your Answer: Candida albicans

      Correct Answer: Pseudomonas aeruginosa

      Explanation:

      Listeria monocytogenes is a gram-positive bacteria that does not produce spores.

      Staphylococcus aureus is a gram-positive bacteria, while Candida albicans is a gram-positive yeast with a single bud.

      Among the choices, gram-negative bacteria include only Klebsiella pneumoniae and Pseudomonas aeruginosa.

      Pseudomonas aeruginosa is an oxidase-positive bacterium, while Klebsiella pneumoniae is an oxidase-negative bacterium.

      P. aeruginosa can cause urinary tract infections (UTIs) and is spread through poor hygiene or contaminated medical equipment or devices, such as catheters that haven’t been fully sterilized.

    • This question is part of the following fields:

      • Infections
      • Microbiology
      21.3
      Seconds

  • Question 16 - A 20-year-old male receives a small cut over his hand while climbing a...

    Incorrect

    • A 20-year-old male receives a small cut over his hand while climbing a fence causing it to bleed. Upon applying pressure for a few minutes, the bleeding stops. Which one of the following physiological components of the blood is responsible for the primary haemostasis reaction, such as in this case?

      Your Answer:

      Correct Answer: Platelet plug formation

      Explanation:

      Haemostasis is your body’s defence against an injury that causes bleeding. It stops bleeding in three main steps:

      1) Primary haemostasis – formation of a weak platelet plug
      – The primary reaction of the body is to cause local vasoconstriction at the site of injury and decrease blood flow to the affected area
      – the release of cytokines and inflammatory markers lead to adhesion of platelets and aggregation at the site of injury forming a platelet plug
      – the injured vessel wall has exposed subendothelial collagen that releases von Willebrand factor

      Any damage to the vessel wall causes the release of the Von Willebrand factor, which is necessary for platelet adhesion. Tissue Thromboplastin is also released, which activates the coagulation pathway, a component of secondary haemostasis. The coagulation cascade ultimately results in the conversion of fibrinogen to fibrin.

      2) Secondary haemostasis
      3) Fibrinolysis

      Fibrin (factor Ia) is a long, thin protein with branches produced at the end of the coagulation cascade when fibrinogen (factor I) is converted to fibrin, which stabilizes the blood clot.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds

  • Question 17 - A patient complains of stomach ache. You see a midline scar in the...

    Incorrect

    • A patient complains of stomach ache. You see a midline scar in the epigastric area when you examine the abdomen. Upon further interrogation, the patient reveals that she had a subtotal gastrectomy for recurring stomach ulcers several years ago. The stomach mucosa secretes a variety of vital compounds, and her ability to secrete some of these molecules has been harmed as a result of his surgery.

      The gastric ECL cells secrete which of the following substances?

      Your Answer:

      Correct Answer: Histamine

      Explanation:

      Enterochromaffin-like cells (ECL cells) are a type of neuroendocrine cell located beneath the epithelium in the stomach glands. They’re most typically located near the parietal cells of the stomach. The ECL cells’ primary role is to produce histamine, which stimulates the formation of stomach acid by the parietal cells.

      The table below summarizes the many cell types found in the stomach, as well as the substances secreted by each cell type and the function of the secretion:

      Cell type/ Substance secreted/ Function of secretion
      Parietal cells/ Hydrochloric acid/ Kills microbes and activates pepsinogen
      Parietal cells/ Intrinsic factor/Binds to vitamin B12 and facilitates its absorption
      Chief cells/ Pepsinogen/ Protein digestion
      Chief cells/ Gastric lipase/ Fat digestion
      G-cells/ Gastrin/ Stimulates gastric acid secretion
      Enterochromaffin-like cells (ECL cells) /Histamine/ Stimulates gastric acid secretion
      Mucous-neck cells/ Mucous and bicarbonate/ Protects stomach epithelium from acid
      D-cells/ Somatostatin/ Inhibits gastric acid secretion

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      0
      Seconds

  • Question 18 - From which of the following cell types are platelets derived? ...

    Incorrect

    • From which of the following cell types are platelets derived?

      Your Answer:

      Correct Answer: Megakaryocytes

      Explanation:

      Synthesis of platelets occurs in the bone marrow by fragmentation of megakaryocytes cytoplasm, derived from the common myeloid progenitor cell. The average time for differentiation of the human stem cell to the production of platelets is about 10 days. The major regulator of platelet formation is thrombopoietin and 95% of this is produced by the liver. Normal platelet count is 150 – 450 x 109/L and the normal lifespan of a platelet is about 10 days. Usually about one-third of the marrow output of platelets may be trapped at any one time in the normal spleen.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 19 - All of the following statements are considered true regarding nominal variables, except: ...

    Incorrect

    • All of the following statements are considered true regarding nominal variables, except:

      Your Answer:

      Correct Answer: The central tendency of a nominal variable is given by its median

      Explanation:

      A nominal variable is a type of variable that is used to name, label or categorize particular attributes that are being measured. It takes qualitative values representing different categories, and there is no intrinsic ordering of these categories.
      A nominal variable is one of the 2 types of categorical variables and is the simplest among all the measurement variables. Some examples of nominal variables include gender, name, phone, etc.

      A nominal variable is qualitative, which means numbers are used here only to categorize or identify objects. They can also take quantitative values. However, these quantitative values do not have numeric properties. That is, arithmetic operations cannot be performed on them. If the variable is nominal, the mode is the only measure of central tendency to use.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds

  • Question 20 - Gallstones are commonly found lodged in which of the following parts of the...

    Incorrect

    • Gallstones are commonly found lodged in which of the following parts of the gallbladder?

      Your Answer:

      Correct Answer: Neck

      Explanation:

      There is a significant association between the presence of Hartmann’s pouch and gallbladder stones. It is the most common location for gallstones to become lodged and cause cholestasis.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      0
      Seconds

  • Question 21 - A 60-year-old man presents with marked breathlessness. He has with a history of...

    Incorrect

    • A 60-year-old man presents with marked breathlessness. He has with a history of ischaemic heart disease. On examination, there is coarse bibasal crackles, marked peripheral oedema and chest X-ray taken is consistent with severe pulmonary oedema. RR is 28 per minute.

      Which receptor is responsible for detecting pulmonary oedema and the subsequent increase in respiratory rate?

      Your Answer:

      Correct Answer: Juxtacapillary receptors

      Explanation:

      Pulmonary oedema causes stimulation of the Juxtacapillary receptors (J receptors) leading to a reflex increase in breathing rate. These receptors are also thought to be involved in the sensation of dyspnoea. The J receptors are sensory cells and are located within the alveolar walls in juxtaposition to the pulmonary capillaries.

      Aortic baroreceptor are involved in detecting blood pressure

      Central chemoreceptors detect changes in CO2 and hydrogen ion within the brain

      Atrial volume receptors regulate plasma volume

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      0
      Seconds

  • Question 22 - What is the pathophysiology of Cushing's syndrome: ...

    Incorrect

    • What is the pathophysiology of Cushing's syndrome:

      Your Answer:

      Correct Answer: Glucocorticoid excess

      Explanation:

      Cushing’s syndrome is the name given to the clinical symptoms and signs induced by chronic glucocorticoid excess.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

  • Question 23 - Regarding control of hospital acquired infection (HAI), which of the following statements is...

    Incorrect

    • Regarding control of hospital acquired infection (HAI), which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Chlorhexidine is an anti-staphylococcal agent.

      Explanation:

      Chlorhexidine is an anti-staphylococcal agent. Cleaning is the removal of foreign material from areas or objects to a point at which they are visually free from debris.  Disinfection is the reduction in the number of infectious particles. Isopropyl alcohol is not effective against C. difficile spores. Autoclaving is a method of sterilisation.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      0
      Seconds

  • Question 24 - A 50-year-old man has recently been on antibiotics for a chest infection. He...

    Incorrect

    • A 50-year-old man has recently been on antibiotics for a chest infection. He suffers from COPD and is currently on Seretide inhalers, salbutamol, and Phyllocontin continus. Since commencing the antibiotics, he has developed nausea, vomiting and abdominal pain.

      Which of the following antibiotics has he MOST LIKELY been on for his chest infection?

      Your Answer:

      Correct Answer: Erythromycin

      Explanation:

      Phyllocontin continues contains aminophylline, a bronchodilator used in the management of asthma and COPD.

      The index patient is exhibiting symptoms of theophylline toxicity. This may have been triggered by the antibiotic he took. Macrolide antibiotics, like erythromycin and quinolone antibiotics, like ciprofloxacin and levofloxacin, increases the plasma concentration of theophyllines and can lead to toxicity.

      Factors that enhance theophylline clearance include cigarette smoking, carbamazepine, phenobarbital, phenytoin, primidone, and rifampin.
      Medications that inhibit clearance include ethanol, ciprofloxacin, erythromycin, verapamil, propranolol, ticlopidine, tacrine, allopurinol, and cimetidine.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds

  • Question 25 - The average BP reading on ambulatory blood pressure monitoring for a 59-year-old Caucasian...

    Incorrect

    • The average BP reading on ambulatory blood pressure monitoring for a 59-year-old Caucasian man is 152/96 mmHg (ABPM).

      The first-line drug treatment for this patient would be which of the following? Please only choose ONE answer.

      Your Answer:

      Correct Answer: Amlodipine

      Explanation:

      An ambulatory blood pressure reading of >150/95 is classified as stage 2 hypertension, according to the NICE care pathway for hypertension, and the patient should be treated with an antihypertensive drug.

      A calcium-channel blocker, such as amlodipine, would be the most appropriate medication for a 59-year-old Caucasian man.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 26 - Regarding the power of a study, which of the following statements is INCORRECT:...

    Incorrect

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

      Your Answer:

      Correct Answer: The power of a study is not affected by data variability.

      Explanation:

      A study should only be undertaken if the power is at least 80%; a study power set at 80% accepts a likelihood of 1 in 5 (20%) of missing a statistically significant difference where one exists.The determinants of power are:the sample size (the power increases with sample size)the variability of the observations (the power increases as the variability decreases)the effect size of interest (the power is greater for a larger expected effect size)and the significance level, α (the power is greater if the significance level is larger); therefore the probability of a type I error increases as the probability of a type II error decreases.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds

  • Question 27 - A 26-year-old male presents to your clinic with the complaint of recurrent fevers...

    Incorrect

    • A 26-year-old male presents to your clinic with the complaint of recurrent fevers over the past three months. On documentation of the fever, it is noted that the fever increases and decreases in a cyclical pattern over a 1-2 week period. After the appropriate investigations, a diagnosis of Pel-Ebstein fever is made.

      Which ONE of the following conditions is most likely to cause this patient's fever?

      Your Answer:

      Correct Answer: Hodgkin lymphoma

      Explanation:

      The release of cytokines from Reed-Sternberg cells can cause fever in patients with Hodgkin lymphoma, which increases and decreases in a cyclical pattern of 1 to 2 weeks. This is called Pel-Ebstein or Ebstein-Cardarelli fever, specifically seen in Hodgkin lymphoma. The fever is always high grade and can reach 40 degrees or higher.

      Cyclical fever in other conditions is common but is not termed as Pel-Ebstein fever. This term is reserved only with Hodgkin lymphoma.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 28 - A patient has suffered a nerve injury that has caused weakness of the...

    Incorrect

    • A patient has suffered a nerve injury that has caused weakness of the pectoralis minor muscle.
      Pectoralis minor receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer:

      Correct Answer: Medial pectoral nerve

      Explanation:

      Pectoralis minor is a thin, triangular muscle that is situated in the upper chest. It is thinner and smaller than pectoralis major. It is innervated by the medial pectoral nerve.
      The origin of pectoralis minor is the 3rdto the 5thribs, near the costal cartilages. It inserts into the medial border and superior surface of the coracoid process of the scapula.
      The main action of pectoralis minor is to draw the scapula inferiorly and anteriorly against the thoracic wall. This serves to stabilise the scapula.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 29 - You're evaluating a 37-year-old woman who is 12 weeks pregnant. She has experienced...

    Incorrect

    • You're evaluating a 37-year-old woman who is 12 weeks pregnant. She has experienced vaginal bleeding.

      Which of the following anti-D statements is correct?

      Your Answer:

      Correct Answer: Routine antenatal prophylaxis is recommended for RhD negative women at 28 and 34 weeks

      Explanation:

      Anti-D is an IgG antibody that targets the antigen Rhesus D (RhD). Plasma from rhesus-negative donors who have been immunised against the anti-D-antigen is used to make anti-D immunoglobulin.

      Only RhD negative women are given Anti-D Ig. Women who are RhD negative do not have the RhD antigen on their RBC. If a foetus has the RhD antigen (i.e. is RhD positive) and the mother is exposed to foetal blood, she may develop antibodies to RhD that pass through the placenta and attack foetal red cells (resulting in newborn haemolytic disease). Anti-D is given to bind and neutralise foetal red cells in the maternal circulation before an immune response is triggered. In the event of a sensitising event, 500 IU Anti-D Ig should be administered intramuscularly.

      The following are examples of potentially sensitising events:
      Birth
      Haemorrhage during pregnancy
      Miscarriage
      Ectopic pregnancy
      Death within the womb
      Amniocentesis
      Chorionic villus sampling
      Trauma to the abdomen

      The sooner anti-D is given in the event of a sensitising event, the better; however, it is most effective within 72 hours, and the BNF states that it is still likely to have some benefit if given outside of this time frame.

      At 28 and 34 weeks, RhD negative women should receive routine antenatal prophylaxis. This is regardless of whether they have previously received Anti-D for a sensitising event during the same pregnancy.

      Prophylactic anti-D is not necessary before 12 weeks gestation, as confirmed by scan, in uncomplicated miscarriage (where the uterus is not instrumented), or mild, painless vaginal bleeding, as the risk of foeto-maternal haemorrhage (FMH) is negligible. In cases of therapeutic termination of pregnancy, whether by surgical or medical means, 250 IU of prophylactic anti-D immunoglobulin should be given to confirmed RhD negative women who are not known to be RhD sensitised.

    • This question is part of the following fields:

      • Immunological Products & Vaccines
      • Pharmacology
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  • Question 30 - Which of these statements about the monospot test is true? ...

    Incorrect

    • Which of these statements about the monospot test is true?

      Your Answer:

      Correct Answer: It can be positive in rubella

      Explanation:

      Infectious mononucleosis can be diagnosed using specific EBV antibodies and a variety of unrelated non-EBV heterophile antibodies.

      Heterophile antibodies:
      About 70-90% of patients with EBV infectious mononucleosis produce antibodies against an antigen produced in one species that react against antigens from other species called heterophile antibodies. False positives can be seen with rubella, hepatitis, SLE, malaria, toxoplasmosis, lymphoma and leukaemia.

      These antibodies can be detected by two main screening tests:
      The monospot test uses horse red blood cells. It agglutinates in the presence of heterophile antibodies.
      Paul-Bunnell test uses sheep red blood cells. The blood agglutinates in the presence of heterophile antibodies.

      EBV-specific antibodies:
      Patients can remain heterophile-negative after six weeks and are then considered to be heterophile-negative and should be tested for EBV-specific antibodies. EBV-specific antibodies test are helpful if a false positive heterophile antibody test is suspected.
      The indirect Coombs test is used to detect in-vitro antibody-antigen reactions. It is typically used in antenatal antibody screening and in preparation for blood transfusion.
      Heterophile antibody tests are generally not positive in the incubation period of infectious mononucleosis (4-6 weeks) before the onset of symptoms.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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SESSION STATS - PERFORMANCE PER SPECIALTY

Immune Responses (0/2) 0%
Pathology (3/5) 60%
Cardiovascular Pharmacology (0/1) 0%
Pharmacology (0/3) 0%
Gastrointestinal (2/2) 100%
Physiology (2/3) 67%
Haematology (2/2) 100%
Infections (0/2) 0%
Abdomen (1/1) 100%
Anatomy (3/3) 100%
Respiratory Physiology (0/1) 0%
Microbiology (1/1) 100%
Pathogens (1/1) 100%
Head And Neck (1/1) 100%
Lower Limb (1/1) 100%
General Pathology (1/1) 100%
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