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Question 1
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The following is true in relation to coronary venous drainage?
Your Answer: Most venous return ultimately drains into right atrium via the coronary sinus
Explanation:Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins. Apart from these there are other vessels that drain directly into the heart chambers
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 2
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Select the CORRECT statement regarding bile salts…
Your Answer: Are necessary for any bile acid secretion by hepatocytes.
Explanation:Bile salts stimulate bile secretion by the liver. Bile salts do not have an enzymatic action on digestion of fat but rather emulsify fat for the action of enzymes secreted mainly by the pancreas. Bile salts are polar cholesterol derivatives and are not derived from amino acids.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 3
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Which of the following statements is the most characteristic of primary Raynaud's phenomena?
Your Answer: Fingers are symmetrically involved during an attack
Explanation:A typical attack may last less than an hour but can also persist for longer. In primary Raynaud’s, attacks are more likely symmetric, episodic, and without evidence of peripheral vascular disease. Patients more commonly have a negative ANA and normal inflammatory markers. There should be no evidence of tissue gangrene, digital pitting, or tissue injury in primary Raynaud’s. In contrast, patients with secondary Raynaud’s will describe attacks that are more frequent, painful, often asymmetric and may lead to digital ulcerations.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 4
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A 76-year-old man has been admitted with a respiratory tract infection. On examination, he was found to be confused and dyspnoeic with O2 saturation of 88%. He has a 60 pack-year smoking history. An arterial blood gas analysis reveals CO2 retention. He has been deemed unfit for admission into the intensive care unit. The physician elects to begin a doxapram infusion. Among the following statements which best fits with the characteristics of doxapram?
Your Answer: Epilepsy is a contraindication for doxapram use
Explanation:The statement that fits the characteristics of doxapram is, epilepsy is a contraindication for doxapram use. Concurrent use with theophylline may increase agitation not relaxation.Doxapram is a central respiratory stimulant. In clinical practice, doxapram is usually used for patients who have an acute exacerbation of chronic obstructive pulmonary disease (COPD) who are unsuitable for admission to the intensive therapy unit for ventilatory support. Doxapram infusion may buy an extra 24 h to allow for recovery.Contraindications include: ischaemic heart disease, epilepsy, cerebral oedema, acute stroke, asthma, hypertension, hyperthyroidism, and pheochromocytoma. The infusion may worsen agitation and dyspnoea and lead to hypertension, nausea, vomiting and urinary retention.Drug interactions:Concomitant administration of doxapram and aminophylline (theophylline) can cause increased skeletal muscle activity, agitation, and hyperactivity.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 5
Correct
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In a 60kg adult male with normal mean arterial pressure and oxygen consumption, what proportion of the cardiac output at rest goes to the brain?
Your Answer: 10-15%
Explanation:The rate of cerebral blood flow in the adult is typically 750 millilitres per minute, which is 10-15% of the cardiac output. On average around 13.9% of cardiac output is distributed to the brain.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 6
Correct
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Periodic fevers occur in humans with mutations in the gene for pyrin. Pyrin is a protein found in which one of the following cells?
Your Answer: Neutrophils
Explanation:Pyrin, also known as marenostrin or TRIM20, is a protein encoded by the Mediterranean fever (MEFV) gene, causing the autoinflammatory disease familial Mediterranean fever (FMF). Pyrin produces an increased sensitivity to intracellular signals. It is produced mainly in neutrophils, which display an increased ratio of cells entering apoptosis when exposed to pyrin.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 7
Correct
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In which phase do chromosomes in the nucleus become condensed into well-defined chromosomes?
Your Answer: Metaphase
Explanation:Prophase begins when the nucleus envelope disintegrates and the chromosomes start to condense. The chromosomes consist of two sister chromatids that are joined at a constriction known as centromere. When the cell reaches the metaphase the chromosomes are completely condensed and ready to align on the equatorial plate
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This question is part of the following fields:
- Genetics
- Medicine
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Question 8
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Question 9
Correct
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A 62 year old female has complained she feels unsteady when she is walking. She is examined and is found to have pyramidal weakness of her left lower leg. She also has reduced pain and temperature sensation on her right leg and right side of her torso up to the umbilicus. Her joint position sense is also impaired in her left big toe but is found to be normal elsewhere. She has definite left extensor plantar response, and the right plantar response is equivocal. Where is the lesion?
Your Answer: Left mid-thoracic cord
Explanation:In Brown-Sequard syndrome, there is paralysis and loss of proprioception, which occurs on the same (ipsilateral) side of the body, as the lesion. Loss of pain and temperature sensation, therefore, occurs on the opposite (contralateral) side of the body as the lesion.
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This question is part of the following fields:
- Geriatrics
- Medicine
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Question 10
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A 27-year-old man presents with a regular tachycardia of 190 bpm. He is healthy and has no past medical history. Blood pressure and blood tests are all within normal parameters however the ECG confirms a narrow complex tachycardia. The tachycardia persists after giving IV adenosine 6mg. What should be the next step in management of this patient?
Your Answer: IV 12mg adenosine
Explanation:For narrow complex tachycardias with no compromise then vagal manoeuvres should be trialled first. The Valsalva manoeuvre should be the first vagal manoeuvre tried and works by increasing intra-thoracic pressure and affecting baroreceptors (pressure sensors) within the arch of the aorta. It is carried out by asking the patient to hold his/her breath while trying to exhale forcibly as if straining during a bowel movement. Adenosine, an ultra-short-acting AV nodal blocking agent, is indicated if vagal manoeuvres are not effective. Adenosine may be safely used during pregnancy. In adults the recommended first dose of intravenous adenosine is 6 mg. The dose is administered rapidly and then followed by a saline flush. Adenosine is only present in the circulation for about 5 seconds, so it is an excellent drug for diagnosis and treatment. If there was a response to adenosine but it was not long lasting, an additional dose of 12 mg of adenosine intravenously can be attempted. Doses greater than 12 mg are not recommended. If adenosine fails then Verapamil or a beta blocker can be used as alternatives. If the patient is hemodynamically unstable or other treatments have not been effective, synchronized electrical cardioversion may be used.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
