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  • Question 1 - After collapsing in his nursing home, a 70-year-old man is brought into the...

    Correct

    • After collapsing in his nursing home, a 70-year-old man is brought into the ER. He is a known case of diabetes mellitus and is on medication for it. An RBS of 2.5 mmol/L (3.9-5.5 mmol/L) is recorded in the ER.

      Out of the following, which medication for diabetes mellitus is MOST likely responsible for his hypoglycaemic episode?

      Your Answer: Pioglitazone

      Explanation:

      Pioglitazone is used to treat type 2 diabetes mellitus. It selectively stimulates the nuclear receptor peroxisome proliferator-activated receptor gamma (PPAR-γ) and to a lesser extent PPAR-α.

      Of the medications mentioned in this question, only pioglitazone is a recognized cause of hypoglycaemia.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      19.9
      Seconds

  • Question 2 - Which of the following terms describes the proportion of individuals with a negative...

    Incorrect

    • Which of the following terms describes the proportion of individuals with a negative test result who actually do not have a disease:

      Your Answer:

      Correct Answer: Negative predictive value

      Explanation:

      Negative predictive value (NPV) is the proportion of individuals with a negative test result who do not have the disease.
      NPV = d/(c+d)

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds

  • Question 3 - A 67-year-old woman arrives at the Emergency Department with chest pain. Flecainide is...

    Incorrect

    • A 67-year-old woman arrives at the Emergency Department with chest pain. Flecainide is one of the medications she is taking.

      Which of the following statements about flecainide mechanism of action is correct?

      Your Answer:

      Correct Answer: Blocks Na+ channels in the heart

      Explanation:

      Flecainide is an antiarrhythmic drug of class Ic that works by blocking the Nav1.5 sodium channel in the heart, prolonging the cardiac action potential and slowing cardiac impulse conduction. It has a significant impact on accessory pathway conduction, particularly retrograde conduction, and significantly reduces ventricular ectopic foci.

      Many different arrhythmias can be treated with flecainide, including:
      Pre-excitation syndromes (e.g. Wolff-Parkinson-White)
      Acute atrial arrhythmias
      Ventricular arrhythmias
      Chronic neuropathic pain

      The use of flecainide is contraindicated in the following situations:
      Abnormal left ventricular function
      Atrial conduction defects (unless pacing rescue available)
      Bundle branch block (unless pacing rescue available)
      Distal block (unless pacing rescue available)
      Haemodynamically significant valvular heart disease
      Heart failure
      History of myocardial infarction
      Long-standing atrial fibrillation where conversion to sinus rhythm not attempted
      Second-degree or greater AV block (unless pacing rescue available)
      Sinus node dysfunction (unless pacing rescue available)

      Flecainide should only be used in people who don’t have a structural heart problem. The CAST trial found a significant increase in sudden cardiac death and all-cause mortality in patients with an ejection fraction of less than 40% after a myocardial infarction, where it tended to be pro-arrhythmic.

      Anti-arrhythmic drugs have a limited and ineffective role in the treatment of atrial flutter. It’s important to keep in mind that flecainide shouldn’t be used by itself to treat atrial flutter. When used alone, there is a risk of inducing 1:1 atrioventricular conduction, which results in an increase in ventricular rate that is paradoxical. As a result, it should be used in conjunction with a beta-blocker or a calcium channel blocker with a rate-limiting effect.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 4 - For the treatment of his atrial fibrillation, a 59-year-old man is about to...

    Incorrect

    • For the treatment of his atrial fibrillation, a 59-year-old man is about to begin taking warfarin. He also takes a number of other medications.

      Which of the following medications will enhance warfarin's effects?

      Your Answer:

      Correct Answer: Erythromycin

      Explanation:

      Many medications, including warfarin, require cytochrome P450 enzymes for their metabolism. When co-prescribing cytochrome p450 enzyme inducers and inhibitors with warfarin, it’s critical to be cautious.

      Inhibitors of the cytochrome p450 enzyme potentiate the effects of warfarin, resulting in a higher INR. To remember the most commonly encountered cytochrome p450 enzyme inhibitors, use the mnemonic O DEVICES:

      O– Omeprazole
      D– Disulfiram
      E– Erythromycin (And other macrolide antibiotics)
      V– Valproate (sodium valproate)
      I– Isoniazid
      C– Ciprofloxacin
      E– Ethanol (acute ingestion)
      S- Sulphonamides

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 5 - A 69-year-old woman with new-onset back pain was diagnosed with osteopenia, osteolytic lesions,...

    Incorrect

    • A 69-year-old woman with new-onset back pain was diagnosed with osteopenia, osteolytic lesions, and vertebral collapse after undergoing a radiographic examination. Her laboratory results revealed anaemia and hypercalcemia. These findings most likely indicate what condition?

      Your Answer:

      Correct Answer: Myeloma

      Explanation:

      Bone pain, pathologic fractures, weakness, anaemia, infection, hypercalcemia, spinal cord compression, and renal failure are all signs and symptoms of multiple myeloma (MM). The patient’s condition matched the signs and symptoms of myeloma.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 6 - A 46-year-old male who is suffering from a chest infection. You decide to start giving...

    Incorrect

    • A 46-year-old male who is suffering from a chest infection. You decide to start giving the patient antibiotics, however he is allergic to penicillin. You consult with one of your co-workers about the best choice of antibiotic to give.

      From the following choices, which is considered an example of bacteriostatic antibiotic?

      Your Answer:

      Correct Answer: Trimethoprim

      Explanation:

      Antibiotics that are bactericidal kill bacteria, while antibiotics that are bacteriostatic limit their growth or reproduction. The antibiotics grouped into these two classes are summarized in the table below:

      Bactericidal antibiotics
      Bacteriostatic antibiotics

      Vancomycin
      Metronidazole
      Fluoroquinolone, such as ciprofloxacin
      Penicillins, such as benzylpenicillin
      Cephalosporin, such as ceftriaxone
      Co-trimoxazole
      Tetracyclines, such as doxycycline
      Macrolides, such as erythromycin
      Sulphonamides, such as sulfamethoxazole
      Clindamycin
      Trimethoprim
      Chloramphenicol

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 7 - Which of the following drug classes may cause bronchoconstriction: ...

    Incorrect

    • Which of the following drug classes may cause bronchoconstriction:

      Your Answer:

      Correct Answer: Beta-blockers

      Explanation:

      Beta-blockers, including those considered to be cardioselective, should usually be avoided in patients with a history of asthma, bronchospasm or a history of obstructive airways disease. However, when there is no alternative, a cardioselective beta-blocker can be given to these patients with caution and under specialist supervision. In such cases the risk of inducing bronchospasm should be appreciated and appropriate precautions taken.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 8 - Which of the following is NOT a typical effect caused by adrenaline: ...

    Incorrect

    • Which of the following is NOT a typical effect caused by adrenaline:

      Your Answer:

      Correct Answer: Bronchoconstriction

      Explanation:

      Actions of adrenaline:
      Cardiovascular system
      – Increased rate and force of cardiac contraction
      – Vasoconstriction of vessels in skin, mucous membranes and splanchnic bed
      – Vasodilation of skeletal muscle vessels
      – Increased cardiac output and blood pressure
      Respiratory system
      – Bronchodilation
      – Increased ventilation rate
      Gastrointestinal system
      – Smooth muscle relaxation
      – Contraction of sphincters
      – Metabolism
      – Decreased insulin release
      – Increased glucagon release
      – Increased thermogenesis
      – Increased glycolysis
      – Increased lipolysis
      Eye
      – Pupillary dilation

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

  • Question 9 - A 4-year-old girl is rushed to the Emergency Department by her grandparents after...

    Incorrect

    • A 4-year-old girl is rushed to the Emergency Department by her grandparents after swallowing some of her grandfather's Warfarin tablets. On further questioning, it turns out that she took 5 of his 3 mg tablets which he needs to take due to a history of atrial fibrillation. The child appears healthy well-oriented in time, place and person, and has normal vitals.

      What is the threshold dose of Warfarin that needs to be ingested for there to be a risk of anticoagulation?

      Your Answer:

      Correct Answer: 0.5 mg/kg

      Explanation:

      The clinical effects of Warfarin occur after a dose of greater than 0.5 mg/kg, and they will be observable 8-10 hours after consumption of the drug. The antidote used for Warfarin is Vitamin K.

      1. In low-risk cases with no apparent bleeding:
      an oral dose of 10 mg vitamin K

      2. If there is clinically significant bleeding
      an intravenous dose of 250-300 mcg/kg

      Activated charcoal:
      in cases of warfarin ingestion
      binds to it and reduces the absorption of warfarin
      the ingestion must have occurred within the last hour
      There is, however, rarely a need for the use of activated charcoal because vitamin K is such as safe and effective antidote.

      Clotting studies, including an INR, can be performed, but small children who have ingested warfarin do not require INRs or follow up if they have been treated with 10 mg vitamin K. This dose of vitamin will completely reverse the anticoagulative effects of warfarin.

      Perform INR if any of the following are present:
      1. Delayed presentation (>6 hours)
      2. Patients with symptoms or signs of anticoagulation
      3. Possible massive ingestion

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 10 - Which of the following best describes digoxin: ...

    Incorrect

    • Which of the following best describes digoxin:

      Your Answer:

      Correct Answer: A positive inotrope and negative chronotrope

      Explanation:

      Digoxin is a cardiac glycoside used in the treatment of atrial fibrillation and flutter, and congestive cardiac failure. It acts by inhibiting the membrane Na/K ATPase in cardiac myocytes. This raises intracellular sodium concentration and increases intracellular calcium availability indirectly via Na/Ca exchange. The increase in intracellular calcium levels causes an increases the force of myocardial contraction (positive inotrope), and slows the heart rate (negative chronotrope).

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 11 - Regarding the foetal oxygen-haemoglobin dissociation curve, which of the following statements is CORRECT:...

    Incorrect

    • Regarding the foetal oxygen-haemoglobin dissociation curve, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: The HbF dissociation curve lies to the left of that for HbA.

      Explanation:

      Foetal haemoglobin (HbF) has a higher affinity for oxygen than adult haemoglobin (HbA) because it’s gamma chains bind 2,3-DPG less avidly than beta chains of HbA. The HbF dissociation curve lies to the left of that for HbA. In the placenta PCO2moves from the foetal to the maternal circulation, shifting the maternal curve further right and the foetal curve further left (the double Bohr effect). The higher affinity of HbF relative to HbA helps transfer oxygen from mother to foetus. Therefore even through blood returning from the placenta to the foetus in the umbilical vein has a PO2of only about 4 kPa, its saturation is 70%. Oxygen transport in the foetus is also helped by a high Hb of about 170 – 180 g/L.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 12 - Damage to this nerve affects the flexor digitorum longus. ...

    Incorrect

    • Damage to this nerve affects the flexor digitorum longus.

      Your Answer:

      Correct Answer: Tibial nerve

      Explanation:

      Like all muscles in the deep posterior compartment of the leg, flexor digitorum longus muscle is innervated by branches of the tibial nerve (root value L5, S1 and S2) which is a branch of sciatic nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 13 - Parathyroid hormone is released by which of the following: ...

    Incorrect

    • Parathyroid hormone is released by which of the following:

      Your Answer:

      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
      0
      Seconds

  • Question 14 - Fibrinoid necrosis is typically seen in which of the following: ...

    Incorrect

    • Fibrinoid necrosis is typically seen in which of the following:

      Your Answer:

      Correct Answer: Malignant hypertension

      Explanation:

      Fibrinoid necrosis occurs in malignant hypertension where increased arterial pressure results in necrosis of smooth muscle wall. Eosinophilic and fibrinous deposits are seen.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      0
      Seconds

  • Question 15 - A 68-year-old female has presented to the Emergency Department with chest pain, palpitations,...

    Incorrect

    • A 68-year-old female has presented to the Emergency Department with chest pain, palpitations, and breathlessness complaints. On ECG, she is diagnosed with ventricular arrhythmia and is administered lidocaine.

      Which of the following is the correct mechanism of action of lidocaine?

      Your Answer:

      Correct Answer: Blocks Na+ channels in the heart

      Explanation:

      Lidocaine is a tertiary amide local anaesthetic and also a class IV antiarrhythmic.

      Like other local anaesthetics, lidocaine works on the voltage-gated sodium ion channel on the nerve cell membranes. It works in the following steps:
      1. diffuses through neural sheaths and the axonal membrane into the axoplasm
      2. binds fast voltage-gated Na+ channels in the neuronal cell membrane and inactivates them
      3. With sufficient blockage, the membrane of the postsynaptic neuron will not depolarise and will be unable to transmit an action potential, thereby preventing the transmission of pain signals

      The same principle applies to Lidocaine’s actions in the heart as it blocks the sodium channels in the conduction system and the myocardium. This raises the threshold for depolarizing, making it less likely for the heart to initiate or conduct any action potential that can cause arrhythmia.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 16 - In the emergency department, a 50-year-old female appears with a lack of sensation...

    Incorrect

    • In the emergency department, a 50-year-old female appears with a lack of sensation over the front two-thirds of her tongue. Taste and salivation are both present. The patient might have damage which of her nerves?

      Your Answer:

      Correct Answer: Lingual nerve

      Explanation:

      The lingual nerve, a branch of the mandibular nerve, transmits sensation to the anterior two-thirds of the tongue.

      The chorda tympani, a branch of the facial nerve, transmits taste to the front two-thirds of the tongue as well as secretomotor innervation to the submandibular and sublingual glands.

      As a result, any damage to the lingual nerve can cause changes in salivary secretion on the affected side, as well as a loss of taste in the anterior two-thirds of the tongue and temporary or permanent sensory changes in the anterior two-thirds of the tongue and the floor of the mouth.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      0
      Seconds

  • Question 17 - A young 20-year-old boy is a known case of type I diabetes mellitus....

    Incorrect

    • A young 20-year-old boy is a known case of type I diabetes mellitus. Today, he presents with polyuria, polydipsia, and abdominal pain in the emergency department. His blood sugar is drawn, which is markedly elevated to 7 mmol/L. Quick ABGs are drawn, which show metabolic acidosis. You diagnose the patient to be suffering from diabetic ketoacidosis (DKA) and immediately commence its treatment protocol in which insulin is also administered.

      Out of the following, which parameter is MOST likely to change due to initiating insulin?

      Your Answer:

      Correct Answer: Potassium

      Explanation:

      Diabetes ketoacidosis is an acute complication of diabetes mellitus. Insulin is administered to achieve euglycemia, and crystalloids or colloidal solution is administered to achieve euvolemia and euelectrolytaemia.

      Potassium levels severely fluctuate during the treatment of DKA, hypokalaemia being more common. Insulin promotes the cell to take up potassium from the extracellular space via increased sodium-potassium pump activity.

      It is important to monitor potassium levels during the treatment of DKA regularly. It is widely suggested that the normal saline shall be used for initial resuscitation, and once the potassium level is retrieved, the patient can be started on potassium replacement should the serum potassium level be between 3.3 and 4.5 mmol/L
      If potassium levels fall below 3.3 mmol/l, insulin administration may need to be interrupted to correct the hypokalaemia.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 18 - You see a patient in the ED with photophobia, petechial rash, headache and...

    Incorrect

    • You see a patient in the ED with photophobia, petechial rash, headache and neck stiffness, and suspect a diagnosis of meningococcal meningitis.

      What is the most appropriate initial management?

      Your Answer:

      Correct Answer: Give ceftriaxone 2 g IV

      Explanation:

      Treatment should be commenced with antibiotics immediately before laboratory confirmation due to the potentially life-threatening nature of the disease.

      In a hospital setting, 2g of IV ceftriaxone (80 mg/kg for a child) or IV cefotaxime (2 g adult; 80 mg/kg child) are the drugs of choice.
      In the prehospital setting, IM benzylpenicillin can be given as an alternative.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 19 - Which of the following increases the tendency for oedema to occur? ...

    Incorrect

    • Which of the following increases the tendency for oedema to occur?

      Your Answer:

      Correct Answer: Increased venous pressure

      Explanation:

      When more fluid is filtered out of the capillaries than can be returned to the circulation by the lymphatics, oedema occurs. Changes that increase capillary hydrostatic pressure or decrease plasma oncotic pressure will increase filtration.
      Arteriolar constriction reduces hydrostatic capillary pressure and transiently increase absorption of fluid.
      Dehydration increases plasma protein concentration and therefore increases plasma oncotic pressure and absorption. Capillary hydrostatic pressure and filtration are increased when there is increased venous pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 20 - Which of the following is NOT a function of antibodies: ...

    Incorrect

    • Which of the following is NOT a function of antibodies:

      Your Answer:

      Correct Answer: Act as antigen receptors on T lymphocytes

      Explanation:

      Antibodies:
      Neutralise toxins and prevent attachment of pathogens
      Target, opsonise or agglutinate (clump together) antigens for phagocytosis
      Activate the complement cascade (leading to lysis or opsonisation of the pathogen)
      Act as antigen receptors on B lymphocytes
      Activate antibody-dependent cell-mediated cytotoxicity by natural killer (NK) cells or T cytotoxic cells
      Provide mucosal immunity (IgA-mediated)
      Stimulate degranulation of mast cells (IgE and IgG mediated)
      Provide passive immunity to the newborn (through transplacental passage of IgG and secretion of IgA in breast milk)

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds

  • Question 21 - Regarding postural hypotension, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding postural hypotension, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Postural hypotension usually causes a reflex bradycardia.

      Explanation:

      On standing from a prone position, gravity causes blood to pool in veins in the legs. Central venous pressure (CVP) falls, causing a fall in stroke volume and cardiac output (due to Starling’s law) and thus a fall in blood pressure. Normally this fall in BP is rapidly corrected by the baroreceptor reflex which causes venoconstriction (partially restoring CVP), and an increase in heart rate and contractility, so restoring cardiac output and blood pressure. Impaired autonomic nervous activity in the elderly accounts for the greater likelihood of postural hypotension. Any symptoms of dizziness, blurred vision or syncope is due to a transient fall in cerebral perfusion that occurs before cardiac output and mean arterial pressure (MAP) can be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
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  • Question 22 - Regarding the hard palate, which of the following statements is CORRECT: ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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  • Question 23 - Regarding aciclovir, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Aciclovir eradicates herpes simplex virus from the body.

      Explanation:

      Aciclovir is active against herpesviruses but does not eradicate latent virus.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
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  • Question 24 - A 26-year old female comes to the Emergency Room with complaints of bloody...

    Incorrect

    • A 26-year old female comes to the Emergency Room with complaints of bloody stools. She reports that prior to the passage of bloody stools, she experienced a sharp pain during defecation. Medical history reveals that she has been experiencing constipation for the past 2 weeks. After completing her medical history and physical examination, the attending physician gives an initial diagnosis of an anal fissure.

      Which of the following nerves transmit painful sensation from the anus, resulting in the pain associated with anal fissure?

      Your Answer:

      Correct Answer: Inferior rectal nerve

      Explanation:

      A fissure in ano is a tear in the anoderm distal to the dentate line. The pathophysiology of anal fissure is thought to be related to trauma from either the passage of hard stool or prolonged diarrhoea. A tear in the anoderm causes spasm of the internal anal sphincter, which results in pain, increased tearing, and decreased blood supply to the anoderm. The site of the anal fissure in the sensitive lower half of the anal canal, which is innervated by the inferior rectal nerve, results in reflex spasm of the external anal sphincter, aggravating the condition. Because of the intense pain, anal fissures may have to be examined under local anaesthesia.

      The inferior rectal nerve is a branch of the pudendal nerve. This nerve runs medially across the ischiorectal fossa and supplies the external anal sphincter, the mucous membrane of the lower half of the anal canal, and the perianal skin.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      0
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  • Question 25 - You're evaluating a male patient who's having a lung function test done. In...

    Incorrect

    • You're evaluating a male patient who's having a lung function test done. In calculating the patient’s functional residual capacity, what parameters should you add to derive the functional residual capacity volume?

      Your Answer:

      Correct Answer: Expiratory reserve volume + residual volume

      Explanation:

      The volume of air that remains in the lungs after a single breath is known as functional residual capacity (FRC). It is calculated by combining the expiratory reserve volume and residual volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      0
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  • Question 26 - Which of the following clinical features would you NOT expect to see in...

    Incorrect

    • Which of the following clinical features would you NOT expect to see in a tibial nerve palsy:

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 27 - All of the following statements are incorrect about insulin except: ...

    Incorrect

    • All of the following statements are incorrect about insulin except:

      Your Answer:

      Correct Answer: Proinsulin is cleaved into insulin and C peptide.

      Explanation:

      Proinsulin is synthesised as a single-chain peptide. A connecting peptide (C peptide) within storage granules is removed by proteases to yield insulin.

      Insulin:
      1. is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds.
      2. is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas.
      3. release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin. However, most output is driven by the rise in plasma glucose concentration that occurs after a meal.
      4. effects are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

  • Question 28 - Regarding basophils, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: They are the second most common type of granulocyte.

      Explanation:

      Basophils are only occasionally seen in normal peripheral blood comprising < 1% of circulating white cells. However, they are the largest type of granulocyte. They have many dark cytoplasmic granules which overlie the nucleus and contain heparin and histamine. They have immunoglobulin E (IgE) attachment sites and their degranulation is associated with histamine release. Basophils are very similar in both appearance and function to mast cells.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds

  • Question 29 - Which of the following statements about neutrophils is TRUE: ...

    Incorrect

    • Which of the following statements about neutrophils is TRUE:

      Your Answer:

      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
      0
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  • Question 30 - A six-year-old boy presents with coryzal symptoms that have persisted for more than...

    Incorrect

    • A six-year-old boy presents with coryzal symptoms that have persisted for more than two weeks. He was born and raised in the Middle East. His mother claims he has been tired and has complained of various 'aches and pains.' On examination, you find splenomegaly and enlarged cervical lymph nodes. His legs and arms are covered in petechiae.

      In this case, what is the most likely diagnosis?

      Your Answer:

      Correct Answer: Acute lymphoblastic leukaemia (ALL)

      Explanation:

      ALL is the most common leukaemia in children, with a peak incidence between the ages of 2 and 5.
      ALL has a wide range of clinical symptoms, but many children present with an acute illness that resembles coryza or a viral infection. ALL also has the following features:
      Weakness and sluggishness all over
      Muscle, joint, and bone pain that isn’t specific
      Anaemia
      Petechiae and unexplained bruising
      Oedema
      Lymphadenopathy
      Hepatosplenomegaly

      The following are typical features of a full blood count in patients with ALL:
      Anaemia (normocytic or macrocytic)
      Leukopenia affects about half of the patients (WCC 4 x 109/l).
      Around 25% of patients have leucocytosis (WCC > 10 x 109/l).
      Around 25% of patients have hyperleukocytosis (WCC > 50 x 109/l).
      Thrombocytopaenia

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrine Pharmacology (1/1) 100%
Pharmacology (1/1) 100%
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