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  • Question 1 - A 23-year-old has a known diagnosis of HIV. Blood is sent to the...

    Incorrect

    • A 23-year-old has a known diagnosis of HIV. Blood is sent to the laboratory for tests.

      AIDS be diagnosed at a CD4 counts below?

      Your Answer: 400 cells/mm 3

      Correct Answer: 200 cells/mm 3

      Explanation:

      A normal CD4 count ranges from 500-1000 cells/mm3.

      At CD4 count of less than 350 cells/mm3 treatment with anti-retroviral therapy should be considered.

      At a CD4 count of >200 cells/mm3 AIDS is diagnosed.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      23.6
      Seconds
  • Question 2 - Regarding a cohort study, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding a cohort study, which of the following statements is INCORRECT:

      Your Answer: The usual outcome measure is the relative risk.

      Correct Answer: It is useful for rare diseases.

      Explanation:

      A cohort study is a longitudinal, prospective, observational study that follows a defined group (cohort) matched to unexposed controls for a set period of time and investigates the effect of exposure to a risk factor on a particular future outcome. The usual outcome measure is the relative risk (risk ratio). A large sample size is required for a rare outcome of interest so it is not useful for rare diseases.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      37.6
      Seconds
  • Question 3 - Regarding the flexor digitorum profundus muscle, which of the following is true? ...

    Incorrect

    • Regarding the flexor digitorum profundus muscle, which of the following is true?

      Your Answer: The medial aspect of the muscle is innervated by the median nerve

      Correct Answer: The medial aspect of the muscle is innervated by the ulnar nerve

      Explanation:

      Flexor digitorum profundus is a fusiform muscle located deep within the anterior (flexor) compartment of the forearm. Along with the flexor pollicis longus and pronator quadratus muscles, it comprises the deep flexor compartment of the forearm.

      Flexor digitorum profundus has a dual innervation:

      (1) The medial part of the muscle, that inserts to the fourth and fifth digits, is innervated by the ulnar nerve (C8-T1);

      (2) The lateral part, that inserts to the second and third digits, is innervated by the median nerve, via anterior interosseous branch (C8-T1).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      53.9
      Seconds
  • Question 4 - Regarding the lung roots, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the lung roots, which of the following statements is CORRECT:

      Your Answer: The vagus nerves pass immediately anterior to the lung roots.

      Correct Answer: Generally the pulmonary arteries lie superior to the pulmonary veins in the lung root.

      Explanation:

      Each lung root contains a pulmonary artery, two pulmonary veins, a main bronchus, bronchial vessels, nerves and lymphatics. Generally the pulmonary artery is superior in the lung root, the pulmonary veins are inferior and the bronchi are somewhat posterior in position. The vagus nerves pass posterior to the lung roots while the phrenic nerves pass anterior to them.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      17
      Seconds
  • Question 5 - You are giving a presentation on the immune system as part of your...

    Correct

    • You are giving a presentation on the immune system as part of your peer-to-peer teaching sessions. Yu are currently discussing phagocytes. Macrophages are derived from which of the following cells:

      Your Answer: Monocytes

      Explanation:

      Monocytes spend only a short time in the marrow and, after circulating for 20-40 hours, leave the blood to enter the tissues where they become macrophages. Macrophages form the reticuloendothelial system in the liver, spleen and lymph nodes. The lifespan of macrophages may be as long as several months or even years. In tissues the macrophages become self-replicating without replenishment from the blood. They assume specific functions in different tissues e.g. dendritic cells which are involved in antigen presentation to T-cells. Macrophages may be activated by cytokines such as IFN-gamma, contact with complement or direct contact with the target cell through leucocyte adhesion molecules.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      31.4
      Seconds
  • Question 6 - A patient suffers a stab wound to the neck. The entry point of...

    Correct

    • A patient suffers a stab wound to the neck. The entry point of the blade is situated within the anterior triangle of the neck.
      Which of the following muscles is most likely to be involved? Select ONE answer only.

      Your Answer: Sternothyroid

      Explanation:

      The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains:
      Muscles: thyrohyoid, sternothyroid, sternohyoid muscles
      Organs: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid gland
      Arteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteries
      Veins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veins
      Nerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerve

      The posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle.
      Contents:
      Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodes
      Nerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexus

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      48.1
      Seconds
  • Question 7 - Which of the following states that the total pressure exerted by a mixture...

    Incorrect

    • Which of the following states that the total pressure exerted by a mixture of gases is equal to the sum of the partial pressures of each of the gases in the mixture:

      Your Answer: Boyle's law

      Correct Answer: Dalton's law

      Explanation:

      Dalton’s law states that when two or more gases, which do not react chemically, are present in the same container, the total pressure is the sum of the partial pressures of each gas.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      22.4
      Seconds
  • Question 8 - A 24 year old male sustained an insect bite and presents with a...

    Incorrect

    • A 24 year old male sustained an insect bite and presents with a red hot arm and acute cellulitis has been diagnosed. The predominant white cells in this type of acute inflammation are:

      Your Answer: Eosinophils

      Correct Answer: Neutrophils

      Explanation:

      Neutrophil polymorphs are the predominant type of white cells in an acute reaction. They pass between endothelial cell junctions to invade damaged tissue so that the effects of injury can be combated. Extravasation occurs with the movement of leukocytes out of the vessel lumen, and is achieved in five phases which are margination, ‘rolling’, adhesion, transmigration and chemotaxis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      11.3
      Seconds
  • Question 9 - Where is angiotensin I primarily converted to angiotensin II: ...

    Correct

    • Where is angiotensin I primarily converted to angiotensin II:

      Your Answer: Lungs

      Explanation:

      Angiotensin I is converted to angiotensin II by the removal of two C-terminal residues by the enzyme angiotensin-converting enzyme (ACE). This primarily occurs in the lungs, although it does also occur to a lesser degree in endothelial cells and renal epithelial cells.
      The main actions of angiotensin II are:
      Vasoconstriction of vascular smooth muscle (resulting in increased blood pressure)
      Vasoconstriction of the efferent arteriole of the glomerulus (resulting in an increased filtration fraction and preserved glomerular filtration rate)
      Stimulation of aldosterone release from the zona glomerulosa of the adrenal cortex
      Stimulation of anti-diuretic hormone (vasopressin) release from the posterior pituitary
      Stimulation of thirst via the hypothalamus
      Acts on the Na+/H+ exchanger in the proximal tubule of the kidney to stimulate Na+reabsorption and H+excretion

    • This question is part of the following fields:

      • Physiology
      • Renal
      10.8
      Seconds
  • Question 10 - A 56-year-old male with a 10-year history of Diabetes Mellitus and Hypertension was...

    Correct

    • A 56-year-old male with a 10-year history of Diabetes Mellitus and Hypertension was rushed to the Emergency Department due to sudden onset crushing chest pain. ECG showed an ST-elevation myocardial infarct in the left anterior descending artery territory. The patient's condition was stabilised and managed with angioplasty, but he sustained significant myocardial damage.

      Which one of the following statements best agrees with the myocardial healing process?

      Your Answer: The left ventricle will likely hypertrophy first to maintain cardiac output

      Explanation:

      Following a myocardial infarction scar tissue formation will take place at the site of the damaged muscle. This places increased load on the rest of the myocardium causing it to hypertrophy. The left ventricle will hypertrophy first as it is pumping blood against a greater afterload as compared to the right ventricle.

      There are three types of cells in the body with regards to the cell cycle: 1. permanent
      2. labile
      3. stable cells

      Permanent cells do not re-enter the cell cycle and remain in G0. If there is a pool of stem cells the stem cells will enter the cell cycle to form more cells. Myocardial cells are a type of permanent cell and there is no pool of stem cells in the heart muscle. The anterior wall will not hypertrophy as it is formed by the right atrium and ventricle and both of these hypertrophy after the left ventricle.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      94.5
      Seconds
  • Question 11 - What is the primary function of the mitochondria? ...

    Correct

    • What is the primary function of the mitochondria?

      Your Answer: The production of the cell's supply of chemical energy

      Explanation:

      The mitochondria is responsible for the production of the cell’s supply of chemical energy. It does this by using molecular oxygen, sugar and small fatty acid molecules to generate adenosine triphosphate (ATP) by a process ss known as oxidative phosphorylation. An enzyme called ATP synthase is required.

      Transcription of ribosomal RNA occurs in the nucleolus

      Production of messenger RNA occur in the nucleus

      Production of lysosome occurs in the Golgi apparatus

      The post-translational processing of newly made proteins occurs in the endoplasmic reticulum

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      11.6
      Seconds
  • Question 12 - A 29 year old woman is unable to invert her foot after sustaining...

    Correct

    • A 29 year old woman is unable to invert her foot after sustaining an injury to her leg playing water-polo. Which of the following nerves are most likely damaged:

      Your Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is primarily produced by the tibialis anterior and the tibialis posterior muscles, innervated by the deep fibular nerve and the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      23.6
      Seconds
  • Question 13 - A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve...

    Incorrect

    • A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve injury. Which of the following will confirm the presence of an ulnar nerve injury?

      Your Answer: Loss of sensation to the skin over the palmar aspect of the lateral one and a half digits

      Correct Answer: Claw hand appearance

      Explanation:

      An ulnar injury may result in abnormal sensations in the little finger and ring finger, usually on the palm side, weakness, and loss of coordination of the fingers.

      A claw like deformity of the hand and wrist is present. Pain, numbness, decreased sensation, tingling, or burning sensation in the areas controlled by the nerve are also possible.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      44.7
      Seconds
  • Question 14 - Which of the following is NOT a common myeloma laboratory finding: ...

    Incorrect

    • Which of the following is NOT a common myeloma laboratory finding:

      Your Answer: IgG paraproteinaemia

      Correct Answer: Elevated serum Bence-Jones protein

      Explanation:

      Myeloma laboratory findings include:
      – The presence of a paraprotein in serum or urine (the paraprotein is IgG in 60 percent of cases, IgA in 20 percent, and light chain only in almost all the rest),
      – Increased serum immunoglobulin-free light chain proteins generated by plasma cells but not coupled with heavy chains 
      – Reduced IgG, IgA, and IgM levels in the blood (immune paresis)
      – Anaemia, whether normochromic, normocytic, or macrocytic. 
      – On a blood film, a Rouleaux formation has been marked.
      – In advanced illness, neutropenia and thrombocytopenia are common.
      – ESR is high.
      – Plasma cells in the bone marrow are overabundant, typically in aberrant forms. – Hypercalcemia
      – Creatinine levels are high.
      – Serum albumin levels are low in advanced illness.
      60 percent of patients have osteolytic lesions, osteoporosis, or pathological fractures.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      22.8
      Seconds
  • Question 15 - A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense,...

    Incorrect

    • A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense, vibratory sense, and discriminatory touch. Upon further physical examination, it was observed that her tongue deviates to the left-hand side. An MRI and CT scan was ordered and results showed that he was suffering a left-sided stroke.

      Branches of which of the following arteries are most likely implicated in the case?

      Your Answer: Posterior inferior cerebellar artery

      Correct Answer: Anterior spinal artery

      Explanation:

      Medial medullary syndrome is a form of stroke that affects the medial medulla of the brain. It is caused by a lesion in the medial part of the medulla, which is due to an infraction of vertebral arteries and/or paramedian branches of the anterior spinal artery.

      It is characterized by contralateral paralysis of the upper and lower limb of the body, a contralateral decrease in proprioception, vibration, and/or fine touch sensation, paresthesias or less commonly dysesthesias in the contralateral trunk and lower limb, and loss of position and vibration sense with proprioceptive dysfunction. Ipsilateral deviation of the tongue due to ipsilateral hypoglossal nerve damage can also be seen.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      56.5
      Seconds
  • Question 16 - Achlorhydria is diagnosed in a 37-year-old individual who has had recurring episodes of...

    Incorrect

    • Achlorhydria is diagnosed in a 37-year-old individual who has had recurring episodes of gastroenteritis. This is an autoimmune illness of the gastric parietal cells that causes insufficient stomach acid production.

      Damage to stomach parietal cells will alter the secretion of which other substance?

      Your Answer: Somatostatin

      Correct Answer: Intrinsic factor

      Explanation:

      Achlorhydria is an autoimmune illness of the gastric parietal cells that causes insufficient stomach acid production. The parietal cells that have been injured are unable to create the necessary amount of stomach acid. As a result, the pH of the stomach rises, food digestion suffers, and the risk of gastroenteritis rises.

      The secretion of hydrochloric acid and intrinsic factor is controlled by the gastric parietal cells, which are epithelial cells in the stomach. These cells can be found in the gastric glands, the fundus lining, and the stomach body.

      In response to the following three stimuli, the stomach parietal cells release hydrochloric acid:

      H2 Histamine receptors are stimulated by histamine (most significant contribution)
      Acetylcholine stimulates M3 Receptors via parasympathetic action.
      CCK2 receptors are stimulated by Gastrin.

      Intrinsic factor, which is essential for vitamin B12 absorption, is also produced by stomach parietal cells.
      Omeprazole is a proton pump inhibitor that is both selective and irreversible. It inhibits the H+/K+-ATPase system present on the secretory membrane of gastric parietal cells, which lowers stomach acid secretion.
      Ranitidine inhibits histamine H2-receptors in a competitive manner. The reversible inhibition of H2-receptors in gastric parietal cells reduces both the volume and concentration of gastric acid.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      34.1
      Seconds
  • Question 17 - How does an action potential in the motor end plate rapidly spread to...

    Incorrect

    • How does an action potential in the motor end plate rapidly spread to the central portions of the muscle cells?

      Your Answer: Sarcoplasmic reticulum

      Correct Answer: Transverse tubules

      Explanation:

      When the concentration of intracellular Ca2+rises, muscle contraction occurs. The pathway of an action potential is down tube-shaped invaginations of the sarcolemma called T-tubules (transverse tubules). These penetrate throughout the muscle fibre and lie adjacent to the terminal cisternae of the sarcoplasmic reticulum. The voltage changes in the T-tubules result in the opening of sarcoplasmic reticulum Ca2+channels and there is there is release of stored Ca2+into the sarcoplasm. Thus muscle contraction occurs via excitation-contraction coupling (ECC) mechanism.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      17.2
      Seconds
  • Question 18 - External haemorrhoids may cause anal pain. When explaining to your patient why it...

    Correct

    • External haemorrhoids may cause anal pain. When explaining to your patient why it does so, which of the following nerves will you point out as being affected?

      Your Answer: Pudendal nerve

      Explanation:

      The pain associated with external haemorrhoids is carried by a branch of the pudendal nerve, specifically the somatic fibres (S2-S4).

      It innervates the external anal sphincter and most of the skin over the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      32.6
      Seconds
  • Question 19 - A 29-year-old female with a swollen red finger presents to your clinic and...

    Correct

    • A 29-year-old female with a swollen red finger presents to your clinic and you suspect that the underlying process is of acute inflammation. You request for some bloods investigations.

      Which statement about histamine as a chemical mediator of the acute inflammatory response is TRUE?

      Your Answer: It increases vascular permeability

      Explanation:

      Histamine increases vascular permeability in the acute inflammatory response.

      Histamine causes vasodilation.

      It is released from Mast cells and basophils, eosinophils and platelets.

      Mast cells and basophils are its primary source

      Nitric oxide (not histamine) is a major factor in endotoxic shock

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      36.8
      Seconds
  • Question 20 - Regarding dermatophytes, which of the following statement is CORRECT: ...

    Correct

    • Regarding dermatophytes, which of the following statement is CORRECT:

      Your Answer: Diagnosis is made from microscopy and culture of skin scrapings, hair samples or nail clippings.

      Explanation:

      Diagnosis is made from microscopy and culture of skin scrapings, hair samples or nail clippings depending on the site of infection. The lesions of ringworm typically have a dark outer ring with a pale centre. Tinea capitis is ringworm affecting the head and scalp. Spread is via direct skin contact. Treatment is usually topical, oral antifungals are reserved for refractory infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      16.2
      Seconds
  • Question 21 - 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: Posterior superior alveolar and anterior ethmoidal arteries

      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
      28
      Seconds
  • Question 22 - The following are all examples of type II hypersensitivity EXCEPT for: ...

    Incorrect

    • The following are all examples of type II hypersensitivity EXCEPT for:

      Your Answer: Incompatible blood transfusions

      Correct Answer: Post-streptococcal glomerulonephritis

      Explanation:

      Examples of type II reactions include:
      Incompatible blood transfusions
      Haemolytic disease of the newborn
      Autoimmune haemolytic anaemias
      Goodpasture’s syndrome
      Rheumatic heart disease
      Bullous pemphigoid

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      21.2
      Seconds
  • Question 23 - A patient presents to your clinic with fever of unknown origin. His...

    Incorrect

    • A patient presents to your clinic with fever of unknown origin. His blood results shows a markedly elevated C-Reactive Protein (CRP) level.

      Which of these is responsible for mediating the release of CRP?

      Your Answer: IL-10

      Correct Answer: IL-6

      Explanation:

      C-reactive protein (CRP) is an acute phase protein produced by the liver hepatocytes. Its production is regulated by cytokines, particularly interleukin 6 (IL-6) and it can be measured in the serum as a nonspecific marker of inflammation.

      Although a high CRP suggest an acute infection or inflammation, it does not identify the cause or location of infection.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      11.7
      Seconds
  • Question 24 - Injury to which nerve can lead to weakness or paralysis of the brachialis...

    Correct

    • Injury to which nerve can lead to weakness or paralysis of the brachialis muscle?

      Your Answer: The musculocutaneous nerve

      Explanation:

      The brachialis muscle is a prime flexor of the forearm at the elbow joint. It is fusiform in shape and located in the anterior (flexor) compartment of the arm, deep to the biceps brachii. The brachialis is a broad muscle, with its broadest part located in the middle rather than at either of its extremities. It is sometimes divided into two parts, and may fuse with the fibres of the biceps brachii, coracobrachialis, or pronator teres muscles. It also functions to form part of the floor of the cubital fossa.

      The brachialis is primarily supplied by the musculocutaneous nerve (C5, C6). In addition, a small lateral portion of the muscle is innervated by the radial nerve (C7).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      11.3
      Seconds
  • Question 25 - On which of the following types of receptors does loperamide act? ...

    Incorrect

    • On which of the following types of receptors does loperamide act?

      Your Answer: Muscarinic receptors

      Correct Answer: Opioid receptors

      Explanation:

      Loperamide inhibits acetylcholine release from the myenteric plexus acts by action on opioid mu-receptors, and this then reduces bowel motility. The intestinal transit time is increased, thereby facilitating water reabsorption.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      6.7
      Seconds
  • Question 26 - A 32-year-old asthmatic patient on theophylline as part of her asthma management...

    Incorrect

    • A 32-year-old asthmatic patient on theophylline as part of her asthma management presents to the Emergency Department with an unrelated medical condition.

      Which of these drugs should be avoided?

      Your Answer: Amitriptyline

      Correct Answer: Clarithromycin

      Explanation:

      Macrolide antibiotics (e.g. clarithromycin and erythromycin) are cytochrome P450 enzyme inhibitors. They increase blood levels of theophylline leading to hypokalaemia, and potentially increasing the risk of Torsades de pointes when they are prescribed together.

      Co-prescription with theophylline should be avoided.

      Factors that enhance theophylline clearance include cigarette smoking, carbamazepine, phenobarbital, phenytoin, primidone, and rifampin.
      Medications that inhibit clearance include ethanol, ciprofloxacin, erythromycin, verapamil, propranolol, ticlopidine, tacrine, allopurinol, and cimetidine.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      19.7
      Seconds
  • Question 27 - A 70-year-old woman presents with right-sided loss of pain and temperature sense on...

    Incorrect

    • A 70-year-old woman presents with right-sided loss of pain and temperature sense on the body as well as left-sided loss of pain and temperature sense on the face. She also has complaints of vertigo, nausea, and tinnitus. Further examination of her cranial nerves suggest the presence of Horner's Syndrome. An MRI and CT scan was ordered and results showed that she is suffering from a left-sided stroke.

      Branches of which of the following arteries are most likely implicated in the case?

      Your Answer: Basilar artery

      Correct Answer: Posterior inferior cerebellar artery

      Explanation:

      Wallenberg syndrome is also known as lateral medullary syndrome and posterior inferior cerebellar artery syndrome. It is the most common posterior circulation ischemic stroke syndrome. The primary pathology of Wallenberg syndrome is occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches.

      It is characterized by vertigo with nystagmus, nausea and vomiting, and sometimes hiccups, dysphonia, dysarthria, and dysphagia often present with ipsilateral loss of gag reflex, ipsilateral ataxia with a tendency to fall to the ipsilateral side, pain and numbness with impaired facial sensation on the face, impaired taste sensation, and impaired pain and temperature sensation in the arms and legs.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      624.7
      Seconds
  • Question 28 - One of your patients is undergoing resuscitation and is in septic shock. The...

    Incorrect

    • One of your patients is undergoing resuscitation and is in septic shock. The intensive care outreach team arrives to assess them and determines that a dobutamine infusion should be started.

      Which of the following receptors does dobutamine primarily affect?

      Your Answer: Dopamine receptors

      Correct Answer: Beta-1 receptors

      Explanation:

      Dobutamine is a synthetic isoprenaline derivative that is used to provide inotropic support to patients with low cardiac output caused by septic shock, myocardial infarction, or other cardiac conditions.

      Dobutamine is a sympathomimetic drug that stimulates beta-1 adrenergic receptors in the heart to produce its primary effect. As a result, it has inotropic properties that increase cardiac contractility and output. It also has a small amount of alpha1- and beta-2-adrenergic activity.

      A summary of the mechanism and effects of different inotropic agents is shown below:
      Inotrope
      Mechanism
      Effects
      Adrenaline (epinephrine)
      Beta-1 and -2 agonist at increasing doses;
      Alpha-agonist at high doses
      Increased cardiac output;
      Vasoconstriction at higher doses
      Noradrenaline (norepinephrine)
      Mainly alpha-agonist;
      Beta-1 and -2 agonist at increasing doses
      Vasoconstriction;
      Some increased cardiac output
      Dopamine
      Dopamine agonist at low doses;
      Beta-1 and -2 agonist at increasing doses;
      Alpha-agonist at high doses
      Increased cardiac output;
      Vasoconstriction at higher doses
      Dobutamine
      Mainly beta-1 agonist
      Increased cardiac output

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      12.3
      Seconds
  • Question 29 - Clostridium difficile primarily causes which of the following infectious diseases: ...

    Correct

    • Clostridium difficile primarily causes which of the following infectious diseases:

      Your Answer: Pseudomembranous colitis

      Explanation:

      Clostridium difficile causes pseudomembranous colitis, an acute inflammatory diarrhoeal disease and an important cause of morbidity and mortality in hospitals. Gas gangrene is primarily caused by Clostridium perfringens. Tetanus is caused by Clostridium tetani. Toxic shock syndrome may be caused by Staphylococcus aureus or Streptococcus pyogenes. Necrotising fasciitis is most commonly caused by Streptococcus pyogenes but has a multitude of causes.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      23.6
      Seconds
  • Question 30 - A 34-year-old male is brought into the Emergency Department by the paramedics after...

    Correct

    • 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: 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
      28.2
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