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  • Question 1 - You suspected typhoid disease in a patient who had recently returned from South...

    Incorrect

    • You suspected typhoid disease in a patient who had recently returned from South America and presented to the emergency department with fever, constipation, and a rose spot rash. Which of the following antibiotics will be administered to this patient?

      Your Answer: Benzylpenicillin

      Correct Answer: Cefotaxime

      Explanation:

      Typhoid fever, often known as enteric fever, is a potentially fatal multi-systemic sickness caused predominantly by Salmonella enterica serotype typhi and, to a lesser extent, paratyphi A, B, and C.

      Cefotaxime is the first-line treatment for typhoid fever (or ceftriaxone). In cases of mild or moderate sickness caused by multiresistant pathogens, azithromycin is an option. If the bacterium is sensitive, ciprofloxacin is an option.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      103.5
      Seconds
  • Question 2 - A 50-year-old man, known hypertensive on amlodipine has been visiting his GP with...

    Correct

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

      What is the MOST LIKELY diagnosis?

      Your Answer: Conn’s syndrome

      Explanation:

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

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

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

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

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      14
      Seconds
  • Question 3 - An increased anion gap metabolic acidosis is typically caused by which of the...

    Correct

    • An increased anion gap metabolic acidosis is typically caused by which of the following?

      Your Answer: Propylene glycol overdose

      Explanation:

      Causes of a raised anion gap acidosis can be remember using the mnemonic MUDPILES:
      -Methanol
      -Uraemia (in renal failure)
      -Diabetic ketoacidosis
      -Propylene glycol overdose
      -Infection/Iron overdose/Isoniazid/Inborn errors of metabolism
      -Lactic acidosis
      -Ethylene glycol overdose
      -Salicylate overdose

    • This question is part of the following fields:

      • Physiology
      • Renal
      132.1
      Seconds
  • Question 4 - Regarding drug interactions with erythromycin, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding drug interactions with erythromycin, which of the following statements is INCORRECT:

      Your Answer: There is an increased risk of myopathy if erythromycin is taken with simvastatin.

      Correct Answer: Erythromycin decreases plasma levels of warfarin.

      Explanation:

      Erythromycin and clarithromycin inhibit cytochrome P450-mediated metabolism of warfarin, phenytoin and carbamazepine and may lead to accumulation of these drugs. There is an increased risk of myopathy (due to cytochrome P450 enzyme CYP3A4 inhibition) if erythromycin or clarithromycin is taken with atorvastatin or simvastatin. Erythromycin increases plasma concentrations of theophylline, and theophylline may also reduce absorption of oral erythromycin. All macrolides can prolong the QT-interval and concomitant use of drugs that prolong the QT interval is not recommended.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      17.4
      Seconds
  • Question 5 - Which of the following best describes the process of opsonisation: ...

    Correct

    • Which of the following best describes the process of opsonisation:

      Your Answer: The coating of foreign particles with molecules which allow easier recognition of that cell by phagocytes

      Explanation:

      An opsonin is any molecule that enhances phagocytosis by marking an antigen for an immune response, for example, immunoglobulin or complement. Opsonisation is the molecular mechanism whereby molecules, microbes, or apoptotic cells are chemically modified to have a stronger attraction to the cell surface receptors on phagocytes and natural killer cells. With the antigen coated in opsonins, binding to immune cells is greatly enhanced. Opsonisation also mediates phagocytosis via signal cascades from cell surface receptors.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      63.2
      Seconds
  • Question 6 - The cutaneous circulation's principal role is thermoregulation. This process is aided by the...

    Incorrect

    • The cutaneous circulation's principal role is thermoregulation. This process is aided by the existence of arteriovenous anastomoses.

      Which of the following anatomical areas has the greatest number of arteriovenous anastomoses?

      Your Answer:

      Correct Answer: Pinna of the ear

      Explanation:

      Short vessels called arteriovenous anastomoses (AVAs) link tiny arteries and veins. They have a large lumen diameter. The strong and muscular walls allow AVAs to completely clog the vascular lumen, preventing blood flow from artery to vein (acting like a sphincter). When the AVAs open, they create a low-resistance connection between arteries and veins, allowing blood to flow into the limbs’ superficial venous plexuses. There is no diffusion of solutes or fluid into the interstitium due to their strong muscle walls.

      AVAs are densely innervated by adrenergic fibres from the hypothalamic temperature-regulation centre. High sympathetic output occurs at normal core temperatures, inducing vasoconstriction of the AVAs and blood flow through the capillary networks and deep plexuses. When the temperature rises, sympathetic output decreases, producing AVA vasodilation and blood shunting from the artery to the superficial venous plexus. Heat is lost to the environment as hot blood rushes near to the skin’s surface.
      AVAs are a specialized anatomical adaptation that can only be found in large quantities in the fingers, palms, soles, lips, and pinna of the ear.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      0
      Seconds
  • Question 7 - Regarding haemoglobin, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Haemoglobin synthesis occurs in mature erythrocytes.

      Explanation:

      Haemoglobin is composed of four polypeptide globin chains each with its own iron containing haem molecule. Haem synthesis occurs largely in the mitochondria by a series of biochemical reactions commencing with the condensation of glycine and succinyl coenzyme A under the action of the key rate-limiting enzyme delta-aminolevulinic acid (ALA) synthase. The globin chains are synthesised by ribosomes in the cytosol. Haemoglobin synthesis only occurs in immature red blood cells.
      There are three types of haemoglobin in normal adult blood: haemoglobin A, A2 and F:
      – Normal adult haemoglobin (HbA) makes up about 96 – 98 % of total adult haemoglobin, and consists of two alpha (α) and two beta (β) globin chains. 
      – Haemoglobin A2 (HbA2), a normal variant of adult haemoglobin, makes up about 1.5 – 3.5 % of total adult haemoglobin and consists of two α and two delta (δ) globin chains.
      – Foetal haemoglobin is the main Hb in the later two-thirds of foetal life and in the newborn until approximately 12 weeks of age. Foetal haemoglobin has a higher affinity for oxygen than adult haemoglobin. 
      Red cells are destroyed by macrophages in the liver and spleen after , 120 days. The haem group is split from the haemoglobin and converted to biliverdin and then bilirubin. The iron is conserved and recycled to plasma via transferrin or stored in macrophages as ferritin and haemosiderin. An increased rate of haemoglobin breakdown results in excess bilirubin and jaundice.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds
  • Question 8 - All of the following cause bronchodilation, EXCEPT for: ...

    Incorrect

    • All of the following cause bronchodilation, EXCEPT for:

      Your Answer:

      Correct Answer: Stimulation of irritant receptors

      Explanation:

      Factors causing bronchodilation: Via beta2-adrenoceptors
      Sympathetic stimulation:
      Adrenaline (epinephrine)
      Beta2-adrenergic agonists e.g. salbutamol
      Anticholinergic and muscarinic antagonists e.g. ipratropium

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 9 - Which of the following statements about lithium treatment is FALSE: ...

    Incorrect

    • Which of the following statements about lithium treatment is FALSE:

      Your Answer:

      Correct Answer: Concomitant treatment with NSAIDs decreases serum-lithium concentration.

      Explanation:

      Lithium levels are raised by NSAIDs because renal clearance is reduced. Lithium is a small ion (74 Daltons) with no protein or tissue binding and is therefore amenable to haemodialysis. Lithium is freely distributed throughout total body water with a volume of distribution between 0.6 to 0.9 L/kg, although the volume may be smaller in the elderly, who have less lean body mass and less total body water. Steady-state serum levels are typically reached within five days at the usual oral dose of 1200 to 1800 mg/day. The half-life for lithium is approximately 18 hours in adults and 36 hours in the elderly.
      Lithium is excreted almost entirely by the kidneys and is handled in a manner similar to sodium. Lithium is freely filtered but over 60 percent is then reabsorbed by the proximal tubules.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 10 - Which of these cell types in the stomach releases pepsinogen? ...

    Incorrect

    • Which of these cell types in the stomach releases pepsinogen?

      Your Answer:

      Correct Answer: Chief cells

      Explanation:

      The gastric chief cells in the stomach wall releases pepsinogen. Pepsinogen is a proenzyme. It mixes with hydrochloric acid in the stomach and is converted to pepsin. Pepsin breaks down proteins into peptides aiding protein digestion.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      0
      Seconds
  • Question 11 - A 67-year-old man with chronic breathlessness is sent for a lung function test.

    Which...

    Incorrect

    • A 67-year-old man with chronic breathlessness is sent for a lung function test.

      Which statement concerning lung function testing is true?

      Your Answer:

      Correct Answer: In restrictive lung disease, the FEV 1 /FVC ratio is usually >0.7

      Explanation:

      In restrictive lung disease, the FEV1/FVC ratio is usually >0.7%.

      In obstructive lung disease, FEV1 is reduced to <80% of normal and FVC is usually reduced. The FEV1/FVC ratio is reduced to <0.7. Airflow obstruction is defined in the NICE guidelines as:
      Mild airflow obstruction = an FEV 1 of >80% in the presence of symptoms
      Moderate airflow obstruction = FEV 1 of 50-79%
      Severe airflow obstruction = FEV 1 of 30-49%
      Very severe airflow obstruction = FEV1<30%. Spirometry is a poor predictor of quality of life in COPD. However, it can be used as part of the assessment of severity of COPD.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      0
      Seconds
  • Question 12 - A young male has presented to you with respiratory depression and small pupils...

    Incorrect

    • A young male has presented to you with respiratory depression and small pupils on examination. You diagnose opioid overdose and immediately start therapy with Naloxone.

      Which of the following statements is TRUE regarding naloxone?

      Your Answer:

      Correct Answer: It can be given by a continuous infusion if repeated doses are required

      Explanation:

      Naloxone is a short-acting, specific antagonist of mu(μ)-opioid receptors. It is used to reverse the effects of opioid toxicity.

      It can be given by a continuous infusion if repeated doses are required and the infusion rate is adjusted according to the vital signs. Initially, the infusion rate can be set at 60% of the initial resuscitative IV dose per hour.

      Naloxone has a shorter duration of action (6-24 hours) than most opioids and so close monitoring according to the respiratory rate and depth of coma and repeated injections are necessary. When repeated doses are needed in opioid addicts, naloxone administration may precipitate a withdrawal syndrome with abdominal cramps, nausea and diarrhoea, but these usually settle within 2 hours.

      An initial dose of 0.4 to 2 mg can be given intravenously and can be repeated at 2 to 3-minute intervals to a maximum of 10mg.

      If the intravenous route is inaccessible, naloxone can be administered via an IO line, subcutaneously (SQ), IM, or via the intranasal (IN) route.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 13 - A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a...

    Incorrect

    • A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a poor response and you administer another nebuliser with ipratropium bromide added on.

      Which statement about ipratropium bromide is true?

      Your Answer:

      Correct Answer: It can trigger acute closed-angle glaucoma

      Explanation:

      Ipratropium bromide is an antimuscarinic drug. It is used in the management of acute asthma and COPD.

      It provides short-term relief in chronic asthma. Short-acting β2agonists are preferred and act more quickly.

      The commonest side effect of ipratropium bromide is dry mouth. Tremor is commonly seen with β2agonists.

      It can trigger acute closed-angle glaucoma in patients that are susceptible.

      First-line treatment for moderate asthma attacks is short-acting β2agonists.

      The BTS guidelines recommend that nebulised ipratropium bromide (0.5 mg 4-6 hourly) be added to β2agonist treatment in patients with a poor initial response to β2agonist therapy or with acute severe or life-threatening asthma.

      Its duration of action is 3-6 hours, maximum effect occurs 30-60 minutes after use, and bronchodilation can be maintained with three times per day dosing.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds
  • Question 14 - A 70-year old male is taken to the Emergency Room after suffering a...

    Incorrect

    • A 70-year old male is taken to the Emergency Room after suffering a traumatic fall while showering. Upon physical examination, the attending physician noted a hyperextended neck, 1/5 muscle strength in both upper extremities, 4/5 muscle strength in both lower extremities, and variable loss in sensation. The patient is placed in the wards for monitoring. For the next 24 hours, anuria is noted.

      Which of the following spinal cord injuries is the most likely diagnosis?

      Your Answer:

      Correct Answer: Central cord syndrome

      Explanation:

      Central cord syndrome is the most common type of incomplete cord injury and almost always occurs due to a traumatic injury. It results in motor deficits that are worse in the upper extremities as compared to the lower extremities. It may also cause bladder dysfunction (retention) and variable sensory deficits below the level of injury.

      The majority of these patients will be older and present with symptoms after a fall with hyperextension of their neck. On examination, patients will have more significant strength impairments in the upper extremities (especially the hands) compared to the lower extremities. Patients often complain of sensory deficits below the level of injury, but this is variable. Pain and temperature sensations are typically affected, but the sensation of light touch can also be impaired. The most common sensory deficits are in a cape-like distribution across their upper back and down their posterior upper extremities. They will often have neck pain at the site of spinal cord impingement.

      Bladder dysfunction (most commonly urinary retention) and priapism can also be signs of upper motor neuron dysfunction. The sacral sensation is usually preserved, but the clinician should assess the rectal tone to evaluate the severity of the compression.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 15 - A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds
  • Question 16 - You have been asked to give a tutorial on common upper limb neurology...

    Incorrect

    • You have been asked to give a tutorial on common upper limb neurology to a group of medical students. You use the example of a man falling from a balcony onto spiked fencing, sustaining a puncture wound to the axilla. This results in an injury to the musculocutaneous nerve. Which of the following clinical features would you LEAST expect to see in this patient:

      Your Answer:

      Correct Answer: Weakness of forearm pronation

      Explanation:

      Flexion of the arm and flexion and supination of the forearm are weakened but not lost entirely due to the actions of the pectoralis major and deltoid, the brachioradialis and the supinator muscles respectively. There is loss of sensation over the lateral aspect of the forearm. Forearm pronation would not be affected as this is primarily produced by the pronator quadratus and pronator teres muscles, innervated by the median nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 17 - What is the main mechanism of action of cyclizine: ...

    Incorrect

    • What is the main mechanism of action of cyclizine:

      Your Answer:

      Correct Answer: Histamine-H1 antagonist

      Explanation:

      Antihistamines e.g. cyclizine, are effective against nausea and vomiting caused by many different conditions, including motion sickness and vertigo. These agents act by inhibiting histamine pathways, and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. There is no evidence that any one antihistamine is superior to another but their duration of action and incidence of adverse effects differ. Adverse effects include drowsiness and antimuscarinic effects such as blurred vision, dry mouth, urinary retention, constipation and confusion.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 18 - A 12-year-old boy presents to you with a history of fever. A rash...

    Incorrect

    • A 12-year-old boy presents to you with a history of fever. A rash began as small red dots on the face, scalp, torso, upper arms and legs shortly afterwards and has now progressed to small blisters and pustules. You make a diagnosis of chickenpox.

      The following complications of chickenpox is the LEAST likely.

      Your Answer:

      Correct Answer: Bronchospasm

      Explanation:

      Chickenpox (varicella zoster) is a highly contagious airborne disease and has an incubation period of between 7-21 days. It often has a prodromal phase when there is a fever, aches and headaches, dry cough, and sore throat before onset of rash.

      Some recognized complications of chickenpox are:
      Orchitis
      Hepatitis
      Pneumonia
      Encephalitis
      Infected spots
      Otitis media
      Myocarditis
      Glomerulonephritis
      Appendicitis
      Pancreatitis

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 19 - Which of the following causes the first heart sound? ...

    Incorrect

    • Which of the following causes the first heart sound?

      Your Answer:

      Correct Answer: Closing of the atrioventricular valves

      Explanation:

      The heart sounds are as a result of the various parts of the cardiac cycle.
      Heart Sound – Phase of Cardiac Cycle – Mechanical Event:
      1st heart sound – Systole starts – there is closure of the atrioventricular (mitral & tricuspid) valves
      2nd heart sound – Systole ends – there is closure of the semilunar (aortic and pulmonary) valves
      3rd heart sound – Early diastole – this is caused by rapid flow of blood from the atria into the ventricles during the ventricular filling phase
      4th heart sound – Late diastole – this is caused by filling of an abnormally stiff ventricle in atrial systole

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 20 - A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found...

    Incorrect

    • A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found to be malignant. Which of the following parts of the body is most likely the origin of this cancerous lymph node?

      Your Answer:

      Correct Answer: Anal canal

      Explanation:

      A cancer of the anal canal below the pectinate line would spread to the superficial inguinal lymph nodes.

      Anal cancer often spreads through lymphatic drainage to the internal iliac lymph nodes in lesions above the pectinate line and to the superficial inguinal lymph nodes in lesions below the pectinate line.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 21 - Insulin binds to the insulin receptor (IR) on cell surfaces to exert its...

    Incorrect

    • Insulin binds to the insulin receptor (IR) on cell surfaces to exert its action. The IR is a very specific transmembrane receptor belonging to the tyrosine kinase receptor class.

      One of these also activates the IR:

      Your Answer:

      Correct Answer: IGF-I

      Explanation:

      Insulin receptor (IR), in addition to being activated by insulin, is also activated by IGF-I and IGF-II.

      The IR is a dimer with two identical subunits spanning the cell membrane and are connected by a single disulphide bond. The two sub-units include: The alpha chain situated on the exterior of the cell membrane and the beta chain spanning the cell membrane in a single segment.

      When insulin is detected, the alpha chains move together folding around the insulin making the beta chains move together, converting them into an active tyrosine kinase. This initiates a phosphorylation cascade increasing the expression of GLUT4 and allowing uptake of glucose by cells.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds
  • Question 22 - A 23-year-old male is referred to your haematology clinic after an acute attack...

    Incorrect

    • A 23-year-old male is referred to your haematology clinic after an acute attack of haemolytic anaemia. He was diagnosed with glucose-6-phosphate dehydrogenase deficiency ten years ago.

      Which ONE of the following options is FALSE with regards to this disorder?

      Your Answer:

      Correct Answer: Acute haemolysis can be triggered by cephalosporin antibiotics

      Explanation:

      Glucose-6-phosphate dehydrogenase deficiency is an X-linked recessive disorder in which there is a deficiency of the enzyme G6PD. This causes instability of red blood cell membranes under oxidative stress leading to haemolysis.

      Triggers include:
      1) Fava beans
      2) Sulphonamides
      3) Primaquine
      4) Anti-TB drugs
      5) Infections

      Most individuals will be asymptomatic until exposed to one of the triggers listed above. It is the commonest human enzyme defect and affects males more than females because of the X-linked inheritance pattern. The use of penicillins and cephalosporins is generally safe.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 23 - On reviewing the ECG of a patient with a history of intermittent palpitations,...

    Incorrect

    • On reviewing the ECG of a patient with a history of intermittent palpitations, you observe prolonged QT interval.

      Which of these can cause prolongation of the QT interval on the ECG?

      Your Answer:

      Correct Answer: Erythromycin

      Explanation:

      Syncope and sudden death due to ventricular tachycardia, particularly Torsades-des-pointes is seen in prolongation of the QT interval.

      The causes of a prolonged QT interval include:
      Erythromycin
      Amiodarone
      Quinidine
      Methadone
      Procainamide
      Sotalol
      Terfenadine
      Tricyclic antidepressants
      Jervell-Lange-Nielsen syndrome (autosomal dominant)
      Romano Ward syndrome (autosomal recessive)
      Hypothyroidism
      Hypocalcaemia
      Hypokalaemia
      Hypomagnesaemia
      Hypothermia
      Rheumatic carditis
      Mitral valve prolapse
      Ischaemic heart disease

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      0
      Seconds
  • Question 24 - The Philadelphia chromosome is a genetic abnormality associated primarily with which of the...

    Incorrect

    • The Philadelphia chromosome is a genetic abnormality associated primarily with which of the following malignancies:

      Your Answer:

      Correct Answer: Chronic myeloid leukaemia

      Explanation:

      Chronic myeloid leukaemia (CML) is a clonal disorder of a pluripotent stem cell. The disease accounts for around 15% of leukaemias and may occur at any age. The diagnosis of CML is rarely difficult and is assisted by the characteristic presence of the Philadelphia (ph) chromosome. This disease occurs in either sex, most frequently between the ages of 40 and 60 years. In up to 50% of cases the diagnosis is made incidentally from a routine blood count. Leucocytosis is the main feature, with a complete spectrum of myeloid cells seen in the peripheral blood. The levels of neutrophils and myelocytes exceed those of blast cells and promyelocytes.Increased circulating basophils are a characteristic feature. Normochromic normocytic anaemia is usual. Platelet count may be increased (most frequently), normal or decreased. The clinical outlook is very good and 90% of patients can expect long-term control of disease.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 25 - Regarding nitrous oxide, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding nitrous oxide, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Nitrous oxide may be used for maintenance of anaesthesia where its use allows reduced dosage of other agents.

      Explanation:

      For anaesthesia, nitrous oxide is commonly used in a concentration of around 50 – 66% in oxygen in association with other inhalation or intravenous agents. Nitrous oxide cannot be used as the sole anaesthetic agent due to lack of potency, but is useful as part of a combination of drugs since it allows reduction in dosage of other agents. Exposure to nitrous oxide for prolonged periods, either by continuous or by intermittent administration, may result in megaloblastic anaemia as a result of interference with the action of vitamin B12. Nitrous oxide increases cerebral blood flow and should be avoided in patients with, or at risk of, raised intracranial pressure. Nitrous oxide may be administered by any trained personnel experienced in its use.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
      Seconds
  • Question 26 - A patient presents with a cough, productive of green sputum and fever. He...

    Incorrect

    • A patient presents with a cough, productive of green sputum and fever. He was commenced on antibiotics 4 days earlier, but his condition has worsened. There is a documented history of penicillin allergy, and the GP prescribed erythromycin.

      Erythromycin exert its pharmacological effect by binding to?

      Your Answer:

      Correct Answer: The 50S subunit of the bacterial ribosome

      Explanation:

      Macrolides are bacteriostatic antibiotics. They act by binding to the 50S subunit of the bacterial ribosome and inhibit translocation, therefore, inhibiting protein synthesis.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds
  • Question 27 - Regarding dynamic compression of the airways, which of the following statements is CORRECT:...

    Incorrect

    • Regarding dynamic compression of the airways, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: It occurs during forced expiration.

      Explanation:

      Dynamic compression occurs because as the expiratory muscles contract during forced expiration, all the structures within the lungs, including the airways, are compressed by the positive intrapleural pressure. Consequently the smaller airways collapse before the alveoli empty completely and some air remains within the lungs (the residual volume). Physiologically this is important as a completely deflated lung with collapsed alveoli requires significantly more energy to inflate. Dynamic compression does not occur in normal expiration because the intrapleural pressure is negative throughout the whole cycle.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 28 - All of the following predisposes to lithium toxicity in patients taking long-term therapy...

    Incorrect

    • All of the following predisposes to lithium toxicity in patients taking long-term therapy EXCEPT:

      Your Answer:

      Correct Answer: Hypernatraemia

      Explanation:

      A common complication of long term lithium therapy results in most cases of lithium intoxication. It is caused by reduced excretion of the drug which can be due to several factors including deterioration of renal function, dehydration, hyponatraemia, infections, and co-administration of diuretics or NSAIDs or other drugs that may interact.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 29 - Which of the following organelles form lysosomes? ...

    Incorrect

    • Which of the following organelles form lysosomes?

      Your Answer:

      Correct Answer: The Golgi apparatus

      Explanation:

      Lysosomes are formed by the Golgi apparatus or the endoplasmic reticulum. Lysosome releases its enzymes and digests the cell when the cell dies.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      0
      Seconds
  • Question 30 - An injury to which nerve affects innervation to the adductor portion of the...

    Incorrect

    • An injury to which nerve affects innervation to the adductor portion of the adductor magnus?

      Your Answer:

      Correct Answer: Posterior branch of the obturator nerve

      Explanation:

      The nerves that supply the adductor magnus muscle have an embryologic origin from the anterior divisions of the lumbosacral plexus and include the obturator nerve, posterior division (L2-4), and the tibial portion of the sciatic nerve (L4). It is innervated by the posterior division of the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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