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Question 1
Incorrect
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The qSOFA score is a bedside prompt designed to identify patients with suspected infection who are at greater risk for a poor outcome outside of the intensive care unit.
Which of the following is one of the criteria used in the qSOFA score? Select ONE answer only.Your Answer: Diastolic blood pressure <60 mmHg
Correct Answer: Respiratory rate >22
Explanation:In February 2016 the Society of Critical Care Medicine published a JAMA article reformatting the definitions of sepsis in an attempt to overcome the shortcomings of the old definitions.
The main changes are a new definition of sepsis, the replacement of the SIRS criteria with the quick Sepsis-related Organ Failure Assessment (qSOFA), and the complete removal of “severe sepsis” as an entity.
The new definition of sepsis is that it is “life-threatening organ dysfunction caused by a dysregulated host response to infection.”
Septic shock is “a subset of sepsis in which underlying circulatory and cellular metabolism abnormalities are profound enough to increase mortality.”
In essence this means that septic shock is sepsis plus the following, despite adequate fluid resuscitation:
Vasopressors required to maintain a MAP > 65 mmHg
Serum lactate > 2 mmol/l
The qSOFA score is a bedside prompt designed to identify patients with suspected infection who are at greater risk for a poor outcome outside of the intensive care unit. It uses the following three criteria:
Hypotension (SBP < 100 mmHg)
Tachypnoea (RR > 22)
Altered mental status (GCS < 15)
The presence of 2 or more of the qSOFA criteria near the onset of infection is associated with greater risk of death or a prolonged intensive care unit stay. -
This question is part of the following fields:
- Pathology
- Pathology Of Infections
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Question 2
Correct
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You examine a child who has been admitted to the paediatric emergency department with a flu-like illness. His parents tell you that he was born with an inborn defect of steroid metabolism and that he was treated for it with hormone replacement therapy.
Which of the following is classified as a steroid hormone?
Your Answer: Aldosterone
Explanation:Hormones can be classified into three categories depending on their chemical composition: amines, peptides (and proteins), and steroids. Amines are made up of single amino acids (for example, tyrosine), peptide hormones are made up of peptides (or proteins), and steroid hormones are made up of cholesterol.
The table below lists some prominent instances of each of these three hormone classes:1. Peptide hormone:
Adrenocorticotropic hormone (ACTH)
Prolactin
Vasopressin
Oxytocin
Glucagon
Insulin
Somatostatin
Cholecystokinin2. Amine hormone:
Adrenaline (epinephrine)
Noradrenaline (norepinephrine)
Dopamine3. Steroid hormone:
Mineralocorticoids (e.g. aldosterone)
Glucocorticoids (e.g. cortisol)
Progestogens
Androgens
Oestrogens -
This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 3
Correct
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Which of the following is NOT a typical side effect of opioid analgesics:
Your Answer: Diarrhoea
Explanation:All opioids have the potential to cause:
Gastrointestinal effects – Nausea, vomiting, constipation, difficulty with micturition (urinary retention), biliary spasm
Central nervous system effects – Sedation, euphoria, respiratory depression, miosis
Cardiovascular effects – Peripheral vasodilation, postural hypotension
Dependence and tolerance -
This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 4
Correct
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What is the main mechanism of action of metoclopramide:
Your Answer: Dopamine antagonist
Explanation:Metoclopramide is a dopamine-receptor antagonist. Blockade of inhibitory dopamine receptors in the GI tract may allow stimulatory actions of ACh at muscarinic synapses to predominate. Metoclopramide also blocks dopamine D2-receptors within the chemoreceptor trigger zone (CTZ). At high doses, it is also thought to have some 5-HT3antagonist activity.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 5
Correct
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A GP is considering prescribing a non-steroidal anti-inflammatory (NSAID) for pain relief for a patient with a knee injury
Which of these statements about NSAIDs is NOT true?Your Answer: Side effects are less commonly seen with indomethacin than naproxen
Explanation:Most NSAIDs act as non-selective inhibitors of the enzyme cyclo-oxygenase (COX). They inhibit both COX-1 and COX-2 isoenzymes.
Only about 60% of patients will respond to any given NSAID.
It can take 21 days of treatment for a clinically appreciable reduction in inflammation to be apparent. If no improvement is seen after 21 days, the NSAID should be changed.
The use of NSAIDs in the 3rd trimester of pregnancy is associated with the following risks: delayed onset of labour, premature closure of ductus arteriosus and foetal kernicterus.
Side effects are lowest in Ibuprofen and highest in indomethacin. so side effects are more commonly seen with indomethacin than naproxen.
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This question is part of the following fields:
- Musculoskeletal Pharmacology
- Pharmacology
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Question 6
Correct
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Which of the following is NOT one of insulin's actions:
Your Answer: Increased gluconeogenesis
Explanation:Insulin has a number of effects on glucose metabolism, including:
Inhibition of glycogenolysis and gluconeogenesis
Increased glucose transport into fat and muscle
Increased glycolysis in fat and muscle
Stimulation of glycogen synthesis
By inhibiting gluconeogenesis, insulin maintains the availability of amino acids as substrates for protein synthesis. Thus, insulin supports protein synthesis through direct and indirect mechanisms. -
This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 7
Correct
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A blood culture was performed from a sample taken from a patient. It was noted that a Gram-negative coccus organism was grown.
Among the following microorganisms, which is considered an example of a Gram-negative coccus?Your Answer: Neisseria menigitidis
Explanation:Staphylococcus aureus = Gram-positive coccus
Bacillus cereus = Gram-positive bacillus
Campylobacter jejuni = Gram-negative bacillus
Escherichia coli = Gram-negative bacillusIn Gram staining, crystal violet is a purple stain that is used to stain the bacteria first. The stained bacteria are decolorized and then stained with a red stain, which is safranin. Bacteria with thick cell walls keep the purple stain and are called Gram-positive. Thin-walled bacteria are easily decolorized so when safranin, the red stain, is placed on the organisms, they become red or Gram-negative.
Neisseria species appear as Gram-negative diplococci because they form pairs and their adjacent ends are flattened that is why they are also described to have a coffee-bean or kidney-bean shape. -
This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 8
Incorrect
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One of your patients is in resuscitation and is suffering from kidney failure. The intensive care outreach team arrives to assess them and determines that a dopamine infusion is necessary.
Dopamine primarily acts on which of the following receptors at low doses?Your Answer: Beta-1 receptors
Correct Answer: Dopamine receptors
Explanation:Dopamine is a catecholamine that occurs naturally and is used to treat low cardiac output, septic shock, and renal failure. It is both adrenaline and noradrenaline’s immediate precursor.
Dopamine acts on D1 and D2 dopamine receptors in the renal, mesenteric, and coronary beds at low doses (1-5 g/kg/min). Dopamine causes a significant decrease in renal vascular resistance and an increase in renal blood flow at these doses. Within this dose range, it is also involved in central modulation of behaviour and movement.
Dopamine stimulates beta- and alpha-adrenergic receptors directly and indirectly at higher doses. Beta-stimulation predominates at a rate of 5-10 g/kg/min, resulting in a positive inotropic effect that increases cardiac output and coronary blood flow. Alpha-stimulation predominates at infusion rates greater than 15 g/kg/min, resulting in peripheral vasoconstriction and an increase in venous return and systolic blood pressure.
Below is a summary of the mechanisms and effects of various inotropic agents:
Inotrope
Mechanism
Effects
Adrenaline (epinephrine)
Beta-1 and -2 agonist at increasing doses;
Alpha-agonist at high doses
Increased cardiac output;
Vasoconstriction at higher doses
Noradrenaline (norepinephrine)
Mainly alpha-agonist;
Beta-1 and -2 agonist at increasing doses
Vasoconstriction;
Some increased cardiac output
Dopamine
Dopamine agonist at low doses;
Beta-1 and -2 agonist at increasing doses;
Alpha-agonist at high doses
Increased cardiac output;
Vasoconstriction at higher doses
Dobutamine
Mainly beta-1 agonist
Increased cardiac output -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 9
Correct
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Which of the following clinical features would you NOT expect to see in a tibial nerve palsy:
Your Answer: Weakened eversion of the foot
Explanation:Damage to the tibial nerve results in loss of plantarflexion of the ankle and weakness of inversion of the foot resulting in a shuffling gait, clawing of the toes and loss of sensation in its cutaneous distribution.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 10
Incorrect
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Regarding co-amoxiclav, which of the following statements is INCORRECT:
Your Answer: Co-amoxiclav therapy is associated with a risk of developing cholestatic jaundice.
Correct Answer: Clavulanic acid acts to inhibit cross-linking of bacterial peptidoglycan polymers.
Explanation:Co-amoxiclav consists of amoxicillin with the beta-lactamase inhibitor clavulanic acid. Clavulanic acid itself has no significant antibacterial activity but, by inactivating beta-lactamases, it makes the combination active against beta-lactamase-producing bacteria that are resistant to amoxicillin.The most common adverse effects of co-amoxiclav include nausea, vomiting, skin rash and diarrhoea. Pseudomembranous colitis should be considered if a person develops severe diarrhoea during or after treatment with co-amoxiclav. Cholestatic jaundice can occur either during or shortly after the use of co-amoxiclav. An epidemiological study has shown that the risk of acute liver toxicity was about 6 times greater with co-amoxiclav than with amoxicillin. Cholestatic jaundice is more common in patients above the age of 65 years and in men; these reactions have only rarely been reported in children. Jaundice is usually self-limiting and very rarely fatal.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 11
Correct
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Which coronary artery is mostly likely affected if an ECG shows ST segment elevation in leads II, III and aVF, and ST segment depression in V1-V3?
Your Answer: Right coronary artery
Explanation:A posterior wall MI occurs when posterior myocardial tissue (now termed inferobasilar), usually supplied by the posterior descending artery — a branch of the right coronary artery in 80% of individuals — acutely loses blood supply due to intracoronary thrombosis in that vessel. This frequently coincides with an inferior wall MI due to the shared blood supply.
The ECG findings of an acute posterior wall MI include the following:
1. ST segment depression (not elevation) in the septal and anterior precordial leads (V1-V4). This occurs because these ECG leads will see the MI backwards; the leads are placed anteriorly, but the myocardial injury is posterior.
2. A R/S wave ratio greater than 1 in leads V1 or V2.
3. ST elevation in the posterior leads of a posterior ECG (leads V7-V9). Suspicion for a posterior MI must remain high, especially if inferior ST segment elevation is also present.
4. ST segment elevation in the inferior leads (II, III and aVF) if an inferior MI is also present.The following ECG leads determine the location and vessels involved in myocardial infarction:
ECG Leads Location Vessel involved
V1-V2 Septal wall Left anterior descending
V3-V4 Anterior wall Left anterior descending
V5-V6 Lateral wall Left circumflex artery
II, III, aVF Inferior wall Right coronary artery (80%) or Left circumflex artery (20%)
I, aVL High lateral wall Left circumflex artery
V1, V4R Right ventricle Right coronary artery
V7-V9 Posterior wall Right coronary artery -
This question is part of the following fields:
- Anatomy
- Thorax
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Question 12
Correct
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A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from the steering wheel of his car after falling asleep while driving headlong into an oncoming HGV lorry. Bruising around his sternum was observed, which appears to be the central point of impact.
Which of the following structures is most likely injured by the blunt force trauma?Your Answer: Right ventricle
Explanation:In its typical anatomical orientation, the heart has 5 surfaces formed by different internal divisions of the heart:
Anterior (or sternocostal) – Right ventricle
Posterior (or base) – Left atrium
Inferior (or diaphragmatic) – Left and right ventricles
Right pulmonary – Right atrium
Left pulmonary – Left ventricle -
This question is part of the following fields:
- Anatomy
- Thorax
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Question 13
Correct
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Which of the following microbes adheres to the genital mucosa using fimbriae:
Your Answer: Neisseria gonorrhoeae
Explanation:Infection of the genital mucosa by Neisseria gonorrhoeae involves attachment to and invasion of epithelial cells. Initial adherence of gonococci to columnar epithelial cells is mediated by type IV pili assembled from pilin subunit PilE proteins and pilus tip-associated PilC proteins, it then invades the epithelial layer, triggering a local acute inflammatory response.
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This question is part of the following fields:
- Microbiology
- Principles
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Question 14
Incorrect
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When a child has mumps, how long should he or she be off from school?
Your Answer: 5 days after swelling has resolved
Correct Answer: 5 days from onset of swelling
Explanation:To avoid the spread of infection, infected patients should be isolated. Patients should avoid going to school, childcare, or job for five days after the swelling has occurred.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 15
Correct
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Regarding the heart sounds in the cardiac cycle, which of the following statements is INCORRECT:
Your Answer: The third heart sound is caused by filling of an abnormally stiff ventricle in atrial systole.
Explanation:Heart Sound – Phase of Cardiac Cycle – Mechanical Event:
First heart sound – Start of systole – Caused by closure of the atrioventricular (mitral & tricuspid) valves
Second heart sound – End of systole – Caused by closure of the semilunar (aortic and pulmonary) valves
Third heart sound – Early diastole – Caused by rapid flow of blood from the atria into the ventricles during the ventricular filling phase
Fourth heart sound – Late diastole – Caused by filling of an abnormally stiff ventricle in atrial systole -
This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 16
Correct
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A 24-year-old athlete drinks a 500 ml hypertonic sports drink before an endurance event he participates in.
Which of the following effects will this cause?Your Answer: The interstitial fluid becomes more concentrated
Explanation:Osmosis is the passive movement of water across a semipermeable membrane from a region of low solute concentration to a region of higher solute concentration.
When hypertonic fluid is ingested:
The plasma becomes CONCENTRATED.The cells lose water and shrink
The intracellular fluid becomes more concentrated.
Water and ions move freely from the plasma into the interstitial fluid and the interstitial fluid becomes more concentrated.
The increased osmotic potential draws water out of the cells. -
This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 17
Correct
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You assess a patient that has suffered a nerve injury that has paralysed her left latissimus dorsi muscle.
Latissimus dorsi receives its innervation from which of the following nerves? Select ONE answer only.Your Answer: Thoracodorsal nerve
Explanation:Latissimus dorsi originates from the lower part of the back, where it covers a wide area. It lies underneath the inferior fibres of trapezius superiorly, and trapezius is the most superficial back muscle.
Superficial muscles of the back showing latissimus dorsi (from Gray’s Anatomy)
Latissimus dorsi has a broad origin, arising from the spinous processes of T6-T12, the thoracolumbar fascia, the iliac crest and the inferior 3 or 4 ribs. The fibres converge into a tendon that inserts into the intertubercular groove of the humerus.
Latissimus dorsi is innervated by the thoracodorsal nerve.
Latissimus dorsi acts to extend, adduct and medially rotate the humerus. It, therefore, raises the body towards the arm during climbing. -
This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 18
Incorrect
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Digoxin exhibits its positive inotropic effect by which of the following mechanisms:
Your Answer: Inhibits Ca2+ release channels on the sarcoplasmic reticulum
Correct Answer: Inhibits the Na+/K+ pump on the myocyte membrane
Explanation:Cardiac glycosides (e.g. digoxin) slow the removal of Ca2+from the cell by inhibiting the membrane Na+pump (Na+/K+ATPase) which generates the Na+gradient required for driving the export of Ca2+by Na+/Ca2+exchange; consequently the removal of Ca2+from the myocyte is slowed and more Ca2+is available for the next contraction.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 19
Incorrect
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A 68-year-old patient shows Low calcium levels and is on dialysis for chronic kidney disease.
What percentage of total serum calcium is in the form of free or ionised Ca 2+?Your Answer: 10%
Correct Answer: 50%
Explanation:Approximately half of total serum calcium is in the free or ionised Ca2+ state, 40% is attached to plasma proteins (mostly albumin), and the remaining 10% is in complexes with organic ions like citrate and phosphate. The ionized form is the only one that works.
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This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 20
Incorrect
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A 6-year-old girl is brought to the nephrology clinic by her mother due to facial oedema. Her lab workup shows proteinuria of 7 g/24 hours and serum albumin levels of 15 g/L. A diagnosis of Nephrotic Syndrome is made, and corticosteroid therapy is initiated.
Which one of the following is the most likely cause of nephrotic syndrome in this patient?Your Answer: Focal segmental glomerulosclerosis
Correct Answer: Minimal change disease
Explanation:Minimal Change Disease is the most common cause of Nephrotic Syndrome in the paediatric population. It may be caused by NSAID use. Electron microscopy shows the fusion of foot processes while light microscopy will appear normal.
Focal segmental glomerulosclerosis causes Nephrotic Syndrome in adults. It is associated with Heroin use and HIV infection. There is a limited response to steroids, and the disease progresses to end-stage renal failure in 5-10 years.
Diabetic nephropathy occurs after a long period of diabetes due to the deposition of amyloid protein leading to a decrease in glomerular filtration.
There is no history of Hepatitis B in this patient and no symptoms of liver disease such as jaundice.
Membranous glomerulonephritis would present with features of Nephritic Syndrome. These would be oedema, haematuria; red blood cell casts in the urine and hypertension.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 21
Correct
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A 42-year-old male patient, presenting with polyuria and polydipsia symptoms had normal blood test results. Upon interview, he had mentioned being in a car accident in which he had a head injury. His polyuria and polydipsia symptoms are most likely associated with which of the following conditions?
Your Answer: Cranial diabetes insipidus
Explanation:Polydipsia is the feeling of extreme thirstiness. It is often linked to polyuria, which is a urinary condition that causes a person to urinate excessively. The cycle of these two processes makes the body feel a constant need to replace the fluids lost in urination. In healthy adults, a 3 liter urinary output per day is considered normal. A person with polyuria can urinate up to 15 liters of urine per day. Both of these conditions are classic signs of diabetes.
The other options are also types of diabetes, except for psychogenic polydipsia (PPD), which is the excessive volitional water intake seen in patients with severe mental illness or developmental disability. However, given the patient’s previous head injury, the most likely diagnosis is cranial diabetes insipidus.
By definition, cranial diabetes insipidus is caused by damage to the hypothalamus or pituitary gland after an infection, operation, brain tumor, or head injury. And the patient’s history confirms this diagnosis. To define the other choices, nephrogenic diabetes insipidus happens when the structures in the kidneys are damaged and results in an inability to properly respond to antidiuretic hormone.
Kidney damage can be caused by an inherited (genetic) disorder or a chronic kidney disorder. As with cranial diabetes insipidus, nephrogenic diabetes insipidus can also cause an elevated urine output.
Diabetes mellitus is classified into two types, and the main difference between them is that type 1 diabetes is a genetic disorder, and type 2 diabetes is diet-related and develops over time. Type 1 diabetes is also known as insulin-dependent diabetes, in which the pancreas produces little or no insulin. Type 2 diabetes is termed insulin resistance, as cells don’t respond customarily to insulin.
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This question is part of the following fields:
- Physiology
- Renal Physiology
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Question 22
Incorrect
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A patient has a cardiac output of 4.8 L/min and a heart rate of 80 bpm, therefore their stroke volume is:
Your Answer: 56 mL
Correct Answer: 60 mL
Explanation:Cardiac output (CO) = Stroke volume (SV) x Heart rate (HR).
Therefore SV = CO/HR
= 4.8/80
= 0.06 L = 60 mL. -
This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 23
Incorrect
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Which of the following is typically a cause of a normal anion gap metabolic acidosis:
Your Answer: Uraemia
Correct Answer: Diarrhoea
Explanation:FUSEDCARS can be used to remember some of the causes of a normal anion gap acidosis:
Fistula (pancreaticoduodenal)
Ureteroenteric conduit
Saline administration
Endocrine (hyperparathyroidism)
Diarrhoea
Carbonic anhydrase inhibitors (e.g. acetazolamide)
Ammonium chloride
Renal tubular acidosis
Spironolactone -
This question is part of the following fields:
- Physiology
- Renal
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Question 24
Incorrect
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Through which of the following anatomical structures does an indirect inguinal hernia pass?
Your Answer: Rectus 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 25
Incorrect
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Regarding forest plots, which of the following is the purpose of this graph?
Your Answer: To highlight the most important data set among a set of different factors
Correct Answer: To graphically display the relative strength of multiple studies attempting to answer the same question
Explanation:The results of meta-analysis are often displayed graphically in a forest plot. A properly constructed forest plot is the most effective way to graphically display the relative strength of multiple studies attempting to answer the same question. A typical meta-analysis consists of three main objectives that include estimation of effect sizes from individual studies and a pooled summary estimate with their confidence intervals (CIs), heterogeneity among the studies, and any publication bias. The forest plot illustrates the first two of these objectives. Forest plots visualize the effect measure and CI of individual studies, which provide the raw data for the meta-analysis, as well the pooled-effect measure and CI. The individual studies also can be grouped in the forest plot by some of their characteristics for ease of interpretation such as by study size or year of publication. When comparing the outcomes between an intervention and a control group, dichotomous outcome variables are expressed as ratios (i.e. odds ratios, ORs or risk ratios, RRs), while for continuous outcomes, a weighted mean difference is reported.
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This question is part of the following fields:
- Evidence Based Medicine
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Question 26
Correct
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Angiotensin II acts to cause all but which one of the following effects:
Your Answer: Inhibit release of ADH from the posterior pituitary gland
Explanation:Angiotensin II acts to:
Stimulate release of aldosterone from the zona glomerulosa of the adrenal cortex (which in turn acts to increase sodium reabsorption)
Cause systemic vasoconstriction
Cause vasoconstriction of the renal arterioles (predominant efferent effect thus intraglomerular pressure is stable or increased, thereby tending to maintain or even raise the GFR)
Directly increase Na+reabsorption from the proximal tubule (by activating Na+/H+antiporters)
Stimulate synthesis and release of ADH from the hypothalamus and posterior pituitary respectively
Stimulate the sensation of thirst
Potentiate sympathetic activity (positive feedback)
Inhibit renin production by granular cells (negative feedback) -
This question is part of the following fields:
- Physiology
- Renal
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Question 27
Incorrect
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A 67-year-old female is admitted under your care with the complaint of shortness of breath and massive pedal oedema. There are fine crepitations up to the mid zones on both lung fields on chest auscultation. When questioned about her medication, she doesn't remember everything she takes but knows that there is a tablet to get rid of excess water.
Out of the following medications, which one increases the osmolality of the filtrate in the glomerulus and the tubule, creating an osmotic effect?Your Answer: Bendroflumethiazide
Correct Answer: Mannitol
Explanation:Mannitol is an osmotic diuretic that stops the absorption of water throughout the tubule, thus increasing the osmolality of both glomerular and tubular fluid. It is used to:
1. decrease intraocular pressure in glaucoma
2. decrease intracerebral pressure
3. oliguria.Furosemide is a loop diuretic that inhibits the Na/K/2Cl transported in the ascending limb of the Loop of Henle.
Bendroflumethiazide is a thiazide diuretic which inhibits the Na/Cl transporter.
Spironolactone is a potassium-sparing diuretic that acts as an aldosterone receptor antagonist.
Acetazolamide is a carbonic anhydrase inhibitor.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 28
Incorrect
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The extensor digitorum longus is supplied by which nerve?
Your Answer: Popliteal nerve
Correct Answer: Deep peroneal nerve
Explanation:The extensor digitorum longus is innervated by the deep fibular nerve (L5, S1), a branch of the common fibular nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 29
Incorrect
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Which of the following organisms can penetrate intact skin:
Your Answer:
Correct Answer: Leptospira spp.
Explanation:Leptospirosis is a bacterial disease caused byLeptospira spp. It is the most common zoonotic infection worldwide.
It is usually contracted by exposure to water contaminated with the urine of infected animals (such as rodents, cattle, and dogs). The most important reservoirs are rodents, and rats are the most common source worldwide.
The bacteria enter the body through the skin or mucous membranes. This is more likely if the skin is broken by leptospirosis is somewhat unusual in that it can enter the body through intact skin. -
This question is part of the following fields:
- Microbiology
- Principles
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Question 30
Incorrect
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At rest, skeletal muscle accounts for between 15-20% of cardiac output and accounts for around 50% of body weight. This can increase to nearly 80% of cardiac output during exercise. Skeletal muscle circulation is highly controlled and has a number of specialized adaptations as a result of this high degree of disparity during exercise, in combination with the diversity in the size of skeletal muscle around the body.
What is the primary mechanism for boosting skeletal muscle blood flow during exercise?
Your Answer:
Correct Answer: Metabolic hyperaemia
Explanation:In skeletal muscle, blood flow is closely related to metabolic rate. Due to the contraction of precapillary sphincters, most capillaries are blocked off from the rest of the circulation at rest and are not perfused. This causes an increase in vascular tone and vessel constriction. As metabolic activity rises, this develops redundancy in the system, allowing it to cope with greater demand. During exercise, metabolic hyperaemia, which is induced by the release of K+, CO2, and adenosine, recruits capillaries. Sympathetic vasoconstriction in the active muscles is overridden by this. Simultaneously, blood flow in non-working muscles is restricted, preserving cardiac output. During exercise, muscle contractions pump blood through the venous system, raising the pressure differential between arterioles and venules and boosting blood flow via capillaries.
Capillary angiogenesis is evident when muscles are used repeatedly (e.g. endurance training). It is a long-term effect, not a quick fix for increased blood flow.
The local partial pressure of alveolar oxygen is the primary intrinsic control of pulmonary blood flow (pAO2). Low pAO2 promotes arteriole vasoconstriction and vice versa. The hypoxic pulmonary vasoconstriction (HPV) reflex allows blood flow to be diverted away from poorly ventilated alveoli and towards well-ventilated alveoli in order to maximize gaseous exchange.
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This question is part of the following fields:
- Cardiovascular Physiology
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
