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  • Question 1 - A 17-year-old male presenting in the department has a history of C3 deficiency.

    C3...

    Incorrect

    • A 17-year-old male presenting in the department has a history of C3 deficiency.

      C3 deficiency is associated with all of the following EXCEPT?

      Your Answer: Increased susceptibility to infections caused by Haemophilus Influenzae

      Correct Answer: Hereditary angioedema

      Explanation:

      C1-inhibitor deficiency is the cause of hereditary angioedema not C3 deficiency,

      All the other statements are correct

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      25.7
      Seconds

  • Question 2 - A 35-year-old man presents with haemoptysis, night sweats, and weight loss. Further examinations...

    Incorrect

    • A 35-year-old man presents with haemoptysis, night sweats, and weight loss. Further examinations were done and a diagnosis of tuberculosis is suspected.

      Which of the following statements is considered correct regarding Mycobacterium tuberculosis?

      Your Answer: The Ghon focus typically appears at the base of the lower lobe of the lung

      Correct Answer: It is impervious to decolourisation with acid

      Explanation:

      Mycobacterium tuberculosis are part of the Mycobacteriaceae family. They are described to have the characteristics of a Gram-positive cell wall but they are not easily stained with Gram stain. This is because their cell wall contains a high lipid content, and this lipid allows the Mycobacteria to bind to alkaline stains with the application and help of heat. Once stained, they are able to resist decolorization even with the use of acid alcohol as the decolourizer, making them very difficult to decolorize, that is why they are known to be acid-fast.

      The Ghon complex is a non-pathognomonic radiographic finding on a chest x-ray that is significant for pulmonary infection of tuberculosis. The location of the Ghon’s focus is usually subpleural and predominantly in the upper part of the lower lobe and lower part of the middle or upper lobe.

      Skeletal tuberculosis of the spine is referred to as Pott disease.

      The risk of reactivation TB is about 3.3% during the first year after a positive PPD skin test and a total of 5% to 15% thereafter in the person’s lifetime. Progression from infection to active disease varies with age and the intensity and duration of exposure. Reactivation TB occurs when there is an alteration or suppression of the cellular immune system in the infected host that favours
      replication of the bacilli and progression to disease.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      116
      Seconds

  • Question 3 - A 38-year-old woman presented to the emergency room after an incident of slipping...

    Incorrect

    • A 38-year-old woman presented to the emergency room after an incident of slipping and falling onto her back and left hip. Upon physical examination, it was noted that she has pain on hip flexion, but normal hip adduction. Which of the following muscles was most likely injured in this case?

      Your Answer:

      Correct Answer: Sartorius

      Explanation:

      The hip adductors are a group of five muscles located in the medial compartment of the thigh. These muscles are the adductor longus, adductor brevis, adductor magnus, gracilis, and pectineus.

      The hip flexors consist of 5 key muscles that contribute to hip flexion: iliacus, psoas, pectineus, rectus femoris, and sartorius.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 4 - You are instructed by a senior to administer Mannitol to an RTA patient...

    Incorrect

    • You are instructed by a senior to administer Mannitol to an RTA patient with increased intracranial pressure.

      Mannitol is a low molecular weight compound that freely filters at the glomerulus and is not reabsorbed.
      Out of the following, which is a contraindication to the use of mannitol?

      Your Answer:

      Correct Answer: Severe pulmonary oedema

      Explanation:

      Mannitol is the most widely used osmotic diuretic that is most commonly used to reduce cerebral oedema and intracranial pressure.
      It is recommended to use mannitol for the reduction of CSF pressure/cerebral oedema in a dose of 0.25-2 g/kg as an intravenous infusion over 30-60 minutes. This can be repeated 1-2 times after 4-8 hours if needed.

      Mannitol has several contraindications and some of them are listed below:
      1. Anuria due to renal disease
      2. Acute intracranial bleeding (except during craniotomy)
      3. Severe cardiac failure
      4. Severe dehydration
      5. Severe pulmonary oedema or congestion
      6. Known hypersensitivity to mannitol

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 5 - The patient is a 78-year-old woman who has recently developed left-sided hemiplegia. A...

    Incorrect

    • The patient is a 78-year-old woman who has recently developed left-sided hemiplegia. A CT head scan is performed, and the diagnosis of an ischaemic stroke is confirmed. Her blood pressure is currently very high, with the most recent measurement being 196/124 mmHg, according to the nurse in charge. While you wait for the stroke team to review her, she asks you to prescribe something to help lower the patient's blood pressure.

      Which of the following is the best drug treatment for this patient's BP reduction?

      Your Answer:

      Correct Answer: Labetalol

      Explanation:

      End-organ damage (e.g. encephalopathy, intracranial haemorrhage, acute myocardial infarction or ischaemia, dissection, pulmonary oedema, nephropathy, eclampsia, papilledema, and/or angiopathic haemolytic anaemia) characterises a hypertensive emergency (also known as ‘accelerated hypertension’ or malignant hypertension’ It’s a life-threatening condition that necessitates rapid blood pressure reduction to avoid end-organ damage and a negative outcome.

      In the setting of a stroke syndrome (i.e., in the presence of focal neurological deficits), hypertensive emergencies usually necessitate a slower and more controlled blood pressure reduction than in other situations. Rapid reduction of MAP in the presence of an ischaemic stroke can compromise blood flow, leading to further ischaemia and worsening of the neurological deficit. In this situation, intravenous labetalol is the drug of choice for lowering blood pressure.

      Significantly elevated blood pressure (>185/110 mmHg) is a contraindication to thrombolysis, but there is some evidence for controlling blood pressure before thrombolysis in exceptional circumstances, when it is only slightly above this threshold.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 6 - Regarding saliva, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding saliva, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Saliva production is decreased by inhibition of the parasympathetic nervous system.

      Explanation:

      At rest, saliva is predominantly produced by the submandibular gland (65%) but when stimulated, the parotid glands produce a higher proportion of the total saliva production (50%) than at rest. Saliva is alkaline and hypotonic to plasma. The predominant digestive enzymes in saliva are alpha-amylase and lingual lipase; lingual lipase is not functionally very important, but alpha-amylase is important for the initiation of starch digestion. Saliva production is decreased by inhibition of the parasympathetic nervous system e.g. by sleep, dehydration, anticholinergic drugs and fear.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds

  • Question 7 - After collapsing at home, a 62-year-old man is transported in an ambulance. He...

    Incorrect

    • After collapsing at home, a 62-year-old man is transported in an ambulance. He is now awake, but he is experiencing palpitations and chest pain. He is rushed to resuscitation and placed on a cardiac monitor, which reveals ventricular tachycardia. An amiodarone infusion is set up.

      Which of these statements about amiodarone is correct?

      Your Answer:

      Correct Answer: It is expressed in breast milk

      Explanation:

      Antiarrhythmic drug amiodarone is used to treat both ventricular and atrial arrhythmias. It’s a class III antiarrhythmic that works by prolonging the repolarization phase of the cardiac action potential, where potassium permeability is normally high and calcium permeability is low.

      Dronedarone is sometimes used instead of amiodarone in certain situations. Although amiodarone is more effective than dronedarone, dronedarone has fewer side effects.

      Grapefruit juice inhibits the metabolism of amiodarone.

      The plasma half-life of amiodarone is very long, ranging from 2 weeks to 5 months. The half-life is about 2 months on average.
      Because amiodarone is excreted in breast milk, it should be avoided by breastfeeding mothers.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 8 - Which of these immunoglobulin molecules can cross the placenta? ...

    Incorrect

    • Which of these immunoglobulin molecules can cross the placenta?

      Your Answer:

      Correct Answer: IgG

      Explanation:

      An important mechanism that provides protection to the foetus is placental transfer of maternal IgG antibodies while his/her humoral response is inefficient. The only antibody class that significantly crosses the human placenta is IgG.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds

  • Question 9 - A 50-year-old man presents with signs and symptoms of an anaphylactic reaction. His...

    Incorrect

    • A 50-year-old man presents with signs and symptoms of an anaphylactic reaction. His GP had recently given him a new medication.

      Which one of these is the most likely medication responsible for the drug-induced anaphylactic reaction?

      Your Answer:

      Correct Answer: Penicillin

      Explanation:

      The most common cause of drug-induced anaphylaxis is penicillin.

      The second commonest cause are NSAIDs. Other drugs associated with anaphylaxis are ACE inhibitors and aspirin.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 10 - You've been summoned to a young man in the resus area who has...

    Incorrect

    • You've been summoned to a young man in the resus area who has an SVT. You decide to use adenosine after trying several vagal manoeuvres without success.

      The use of adenosine is not contraindicated in which of the following situations?

      Your Answer:

      Correct Answer: Concurrent use of a beta-blocker

      Explanation:

      The use of a beta-blocker at the same time increases the risk of myocardial depression, but it is not a contraindication.
      The use of adenosine is contraindicated in the following situations:
      Asthma
      COPD (chronic obstructive pulmonary disease)
      Decompensated heart failure 
      Long QT syndrome
      AV block in the second or third degree
      Sinusitis is a condition in which the sinuses become (unless pacemaker fitted)
      Hypotension that is severe

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 11 - Regarding gas exchange at the alveolar-capillary membrane, which of the following statements is...

    Incorrect

    • Regarding gas exchange at the alveolar-capillary membrane, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Transfer of oxygen is usually perfusion-limited.

      Explanation:

      Gas exchange between alveolar air and blood in the pulmonary capillaries takes place by diffusion across the alveolar-capillary membrane. Diffusion occurs from an area of high partial pressure to an area of low partial pressure, thus the driving force for diffusion is the alveolar-capillary partial pressure gradient. Diffusion occurs until equilibrium is reached, but random movement of particles continues to occur and this is known as dynamic equilibrium. The diffusing capacity for oxygen (DLO2) cannot be measured directly but the rate of diffusion in the lungs can be estimated by measuring the diffusing capacity of the lungs for carbon monoxide (DLCO), not by measuring total lung capacity. The rate of transfer of a gas may be diffusion or perfusion limited; carbon monoxide transfer is diffusion-limited, oxygen transfer is usually perfusion-limited.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 12 - A 70 year old man who has a previous history of small cell...

    Incorrect

    • A 70 year old man who has a previous history of small cell lung cancer was found to have severe hyponatraemia on a recent blood test and he is sent to the emergency room. In the nephron, where is the likely cause of this abnormality?

      Your Answer:

      Correct Answer: Distal nephron

      Explanation:

      In the cancer patient, hyponatremia is usually caused by the syndrome of inappropriate antidiuretic hormone (SIADH). This develops more frequently with small cell lung cancer (SCLC) than with other malignancies. The pathogenesis of this is as a result of the process whereby ADH binds V2 receptors on renal principal cells in the late distal tubule and collecting ducts, resulting in elevation of cAMP levels. Increased cAMP levels cause fusion of intracellular vesicles with the apical membrane. There are water channels called aquaporins in their membranes of these vesicles, and these increase the water permeability, thus facilitating increased water reabsorption and urine concentration. Thus, by increasing water retention, ADH causes blood to be diluted, which then decreases the concentration of solutes like sodium.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

  • Question 13 - A diagnosis of acute osteomyelitis was made on a patient with a known...

    Incorrect

    • A diagnosis of acute osteomyelitis was made on a patient with a known history of sickle cell disease. He has no joint prosthesis on in-dwelling metal work and no known drug allergies.

      Which of the following is most likely the causative agent of the case presented above?

      Your Answer:

      Correct Answer: Salmonella spp .

      Explanation:

      Patients with sickle cell disease are prone to infection of the bone and bone marrow in areas of infarction and necrosis. Although Staphylococcus aureus is the most common cause of osteomyelitis in the general population, studies have shown that in patients with sickle cell disease, the relative incidence of Salmonella osteomyelitis is twice that of staphylococcal infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 14 - Regarding platelets, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding platelets, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Platelets are produced in the bone marrow by fragmentation of the cytoplasm of megakaryocytes.

      Explanation:

      Platelets are produced in the bone marrow by fragmentation of the cytoplasm of megakaryocytes, derived from the common myeloid progenitor cell. The time interval from differentiation of the human stem cell to the production of platelets averages 10 days. Thrombopoietin is the major regulator of platelet formation and 95% of this is produced by the liver. The normal platelet count is approximately 150 – 450 x 109/L and the normal platelet lifespan is 10 days. Under normal circumstances, about one-third of the marrow output of platelets may be trapped at any one time in the normal spleen.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 15 - A 19-year-old woman presents with dysuria and vaginal discharge. A swab was taken...

    Incorrect

    • A 19-year-old woman presents with dysuria and vaginal discharge. A swab was taken for culture. Culture results showed the presence of Neisseria gonorrhoeae infection. Treatment of azithromycin and doxycycline was started.

      Which of the following statements is considered correct regarding Neisseria gonorrhoeae?

      Your Answer:

      Correct Answer: Throat swabs can be used for diagnosis

      Explanation:

      Neisseria gonorrhoeae is a Gram-negative diplococcus that causes gonorrhoea. Gonorrhoea is an acute pyogenic infection of nonciliated columnar and transitional epithelium; infection can be established at any site where these cells are found. Gonococcal infections are primarily acquired by sexual contact and occur primarily in the urethra, endocervix, anal canal, pharynx, and conjunctiva.

      In men, acute urethritis, usually resulting in purulent discharge and dysuria (painful urination), is the most common manifestation. The endocervix is the most common site of infection in women. Symptoms of infection, when present, include dysuria, cervical discharge, and lower abdominal pain. Some cases in women may be asymptomatic leading to complications such as pelvic inflammatory disease. Blood-borne dissemination occurs in less than 1% of all infections, resulting in purulent arthritis and rarely septicaemia. Fever and a rash on the extremities can also be present. Other conditions associated with N. gonorrhoeae include anorectal and oropharyngeal infections. Infections in these sites are more common in men who have sex with men but can also occur in women.

      Pharyngitis is the chief complaint in symptomatic oropharyngeal infections, whereas discharge, rectal pain, or bloody stools may be seen in rectal gonorrhoea. Approximately 30% to 60% of women with genital gonorrhoea have concurrent rectal infection. Newborns can acquire ophthalmia neonatorum, a gonococcal eye infection, during vaginal delivery through an infected birth canal.

      Specimens collected for the recovery of N. gonorrhoeae may come from genital sources or from other sites, such as the rectum, pharynx, and joint
      fluid. According to the 2010 STD Treatment guidelines, cephalosporins (e.g., ceftriaxone, cefixime) are currently recommended treatments.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 16 - A 34-year-old male is brought into the Emergency Department by the paramedics after...

    Incorrect

    • A 34-year-old male is brought into the Emergency Department by the paramedics after a road traffic accident. After a quick triage, you establish that he will need to be intubated, and you ask for some ketamine to be prepared.

      Which one of the following options regarding this drug is true?

      Your Answer:

      Correct Answer: It is the only anaesthetic agent available that has analgesic, hypnotic, and amnesic properties

      Explanation:

      Ketamine is a dissociative anaesthetic with analgesic, amnesic, and hypnotic effects. It is the only anaesthetic agent which causes all three of these effects.

      Ketamine exerts its action by non-competitive antagonism at the NMDA (N-methyl-D-aspartate) receptor. Due to its analgesic property, Ketamine is given so that patients do not retain memories of short term procedures. Ketamine is used for the induction and maintenance of anaesthesia in general surgery and for treating burn wounds, battlefield injuries, and children who cannot tolerate other anaesthetic or analgesic agents.

      It can be given by both intravenous and intramuscular routes. Ketamine causes cardiac stimulation by increasing the sympathetic tone. The major side effect is increased intracranial pressure as an increase in the sympathetic tone causes vasoconstriction and an increase in the MAP.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
      Seconds

  • Question 17 -
    A patient with Conn’s syndrome will experience which of the following clinical features?
    ...

    Incorrect


    • A patient with Conn’s syndrome will experience which of the following clinical features?

      Your Answer:

      Correct Answer: Hypernatraemia

      Explanation:

      Conditions to consider in the differential diagnosis of primary aldosteronism or Conn’s syndrome include hypertension, metabolic alkalosis, hypokalaemia, hypernatremia, and low renin levels.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

  • Question 18 - You review a patient with a history of Addison’s disease. He takes 100...

    Incorrect

    • You review a patient with a history of Addison’s disease. He takes 100 mg of hydrocortisone per day to control this.
      What dose of prednisolone is equivalent to this dose of hydrocortisone? Select ONE answer only.

      Your Answer:

      Correct Answer: 25 mg

      Explanation:

      Prednisolone is four times more potent than hydrocortisone, and therefore, a dose of 25 mg would be equivalent to 100 mg of hydrocortisone.
      The following table summarises the relative potency of the main corticosteroids compared with hydrocortisone:
      Corticosteroid
      Potency relative to hydrocortisone
      Prednisolone
      4 times more potent
      Triamcinolone
      5 times more potent
      Methylprednisolone
      5 times more potent
      Dexamethasone
      25 times more potent

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 19 - 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
      0
      Seconds

  • Question 20 - Which of the following is the primary indication for loop diuretics? ...

    Incorrect

    • Which of the following is the primary indication for loop diuretics?

      Your Answer:

      Correct Answer: Acute pulmonary oedema

      Explanation:

      Loop diuretics have long been the cornerstone of pulmonary oedema treatment, with furosemide being the most commonly used of these drugs. Premedication with drugs that decrease preload (e.g., nitro-glycerine [NTG]) and afterload (e.g., angiotensin-converting enzyme [ACE] inhibitors) before the administration of loop diuretics can prevent adverse hemodynamic changes.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 21 - A 17-year-old student presents with a headache and petechial rash. A diagnosis of...

    Incorrect

    • A 17-year-old student presents with a headache and petechial rash. A diagnosis of meningitis was suspected, with a causative agent of Neisseria meningitidis.

      Which of the following statements is considered correct regarding Neisseria meningitidis?

      Your Answer:

      Correct Answer: The antiphagocytic polysaccharide capsule is the main determinant of its pathogenicity

      Explanation:

      N. meningitidis is a Gram-negative cocci and can be found as a commensal as well as an invasive pathogen. It is an important etiologic agent of endemic and epidemic meningitis and meningococcaemia and rarely pneumonia, purulent arthritis, or endophthalmitis. N. meningitidis has also been recovered from urogenital and rectal sites as a result of oral-genital contact. Meningococcal carriage, usually involving nonencapsulated strains, may cause an increase in protective antibody against the pathogenic strains. Of the 12 meningococcal encapsulated serogroups, A, B, C, Y, and W-135 account for most cases of disease in the world. N. meningitidis possesses a polysaccharide capsule that is antiphagocytic and serves as an important virulence factor.

      It can be found on the mucosal surfaces of the nasopharynx and oropharynx in 30% of the human population. The organism is transmitted by close contact with respiratory droplet secretions from a carrier to a new host. Only a few newly colonized hosts develop meningococcal disease, with the highest incidence being found in infants and adolescents.

      The quadrivalent vaccine Menactra is a polysaccharide-protein conjugated vaccine with antigens to serogroups A, C, Y, and W-135. This conjugate vaccine is licensed for people 2 to 55 years old. This vaccine does not protect against meningitis caused by serogroup B because group B polysaccharide is a very poor immunogen in humans.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 22 - A 39-year-old guy comes to the emergency room with a persistent nasal bleed....

    Incorrect

    • A 39-year-old guy comes to the emergency room with a persistent nasal bleed. You suspect the bleeding is coming from Little's area based on your examination. Which of the blood vessels listed below is most likely to be involved:

      Your Answer:

      Correct Answer: Sphenopalatine and superior labial arteries

      Explanation:

      The Kiesselbach plexus is a vascular network formed by five arteries that supply oxygenated blood to the nasal septum, which refers to the wall separating the right and left sides of the nose. The five arteries that form the Kiesselbach plexus: the sphenopalatine artery, which branches from the maxillary artery originating behind the jawbone; the anterior ethmoidal artery, which branches from the ophthalmic artery behind the eye; the posterior ethmoidal artery, which also branches from the ophthalmic artery; the septal branch of the superior labial artery, which is a branch of the facial artery supplying blood to all of the superficial features of the face; and finally, the greater palatine artery, which is a terminal branch of the maxillary artery.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds

  • Question 23 - Which of the following drugs is first line treatment for a stable regular...

    Incorrect

    • Which of the following drugs is first line treatment for a stable regular broad-complex tachycardia:

      Your Answer:

      Correct Answer: Amiodarone

      Explanation:

      A regular broad-complex tachycardia is likely to be ventricular tachycardia or a regular supraventricular rhythm with bundle branch block. A ventricular tachycardia (or broad-complex tachycardia of uncertain origin) should be treated with amiodarone 300 mg IV over 10 – 60 min, followed by an infusion of 900 mg over the next 24 hours. If previously confirmed as SVT with bundle branch block, the patient should be treated as for narrow-complex tachycardia.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 24 - A 29-year-old woman with a skin infection not responding to first-line antibiotics return...

    Incorrect

    • A 29-year-old woman with a skin infection not responding to first-line antibiotics return for a review clinic appointment. The result of her culture shows growth of methicillin-resistant Staphylococcus aureus (MRSA).

      Which among the following antibiotics is methicillin-resistant Staphylococcus aureus usually sensitive to?

      Your Answer:

      Correct Answer: Linezolid

      Explanation:

      Historically, MRSA has been treated successfully with outpatient oral sulphonamides, clindamycin, rifampin, doxycycline, or a combination of these agents. With the development of increasing drug resistance of MRSA to these traditional antimicrobials, there has been a search for more effective antibiotics. One recent study demonstrated that vancomycin, linezolid, and quinupristin-dalfopristin were the most effective antibiotics against multiple strains of MRSA.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 25 - A 32-year-old female is diagnosed case of bipolar disorder and is on medication....

    Incorrect

    • A 32-year-old female is diagnosed case of bipolar disorder and is on medication. She presents to her psychiatric team with symptoms of severe depression. She is currently taking Lithium.

      Out of the following, which is TRUE regarding lithium?

      Your Answer:

      Correct Answer: It commonly causes a tremor

      Explanation:

      Lithium is the drug of choice for bipolar disorders but is commonly associated with side effects and toxicity.

      Fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy with Lithium. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer. Lithium tremors are more common with older age, presumably due to the additive effects of age-related essential tremors.

      Option The normal therapeutic range is 2.0-2.5 mmol/l: Lithium should be carefully monitored as it has a very low therapeutic index. The normal therapeutic range is 0.4-0.8 mmol/l. Levels should be checked one week after starting therapy and one week after every change in dosage. (Option Levels should be checked one month after starting therapy)

      Option It can induce hyperthyroidism: Lithium has a known effect on thyroid function. Lithium decreases the production of T4 and T3 and commonly causes hypothyroidism. More rarely, lithium causes hyperthyroidism due to thyroiditis.

      Option It can induce diabetes mellitus: Lithium can induce nephrogenic diabetes insipidus but not diabetes mellitus.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 26 - A suspicious growth on the posterior tongue of a 40-year-old man was discovered...

    Incorrect

    • A suspicious growth on the posterior tongue of a 40-year-old man was discovered by his dentist and was immediately referred for possible oral cancer.

      The lymph from the posterior tongue will drain to which of the following nodes?

      Your Answer:

      Correct Answer: Deep cervical nodes

      Explanation:

      Lymph from the medial anterior two thirds of the tongue travels to the deep cervical lymph nodes.
      Lymph from the lateral anterior tongue goes to the submandibular nodes.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds

  • Question 27 - 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 28 - A 68-year-old patient shows Low calcium levels and is on dialysis for chronic...

    Incorrect

    • 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:

      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.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds

  • Question 29 - The average BP reading on ambulatory blood pressure monitoring for a 59-year-old Caucasian...

    Incorrect

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

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

      Your Answer:

      Correct Answer: Amlodipine

      Explanation:

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

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

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 30 - An analytical cohort study is done to compare the relationship between omega 3...

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    • An analytical cohort study is done to compare the relationship between omega 3 intake and occurrence of myocardial infarction (MI) among males aged over 65 years. The following are the data from the study:

      No. of subjects taking placebo: 100 men
      No. of subjects taking placebo who suffered an MI: 15 men

      No. of subjects taking omega 3: 100 men
      No. of subjects taking omega 3 who suffered an MI: 5 men

      Compute for the relative risk of the study.

      Your Answer:

      Correct Answer: 0.33

      Explanation:

      Relative risk (RR) is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.

      RR can be computed as the absolute risk of events in the treatment group (ART), divided by the absolute risk of events in the control group (ARC).

      RR = ART/ARC
      RR = (5/100) / (15/100)
      RR = 0.33

    • This question is part of the following fields:

      • Evidence Based Medicine
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