00
Correct
00
Incorrect
00 : 00 : 0 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - The Meissner’s plexus acts as the main control for gastrointestinal secretion and local...

    Correct

    • The Meissner’s plexus acts as the main control for gastrointestinal secretion and local blood flow within the gut.

      The Meissner’s plexus lies in which layer of the gut wall?

      Your Answer: Submucosa

      Explanation:

      The Meissner’s plexus (submucosal plexus), an enteric nervous plexus, acts as the main control for gastrointestinal secretion and local blood flow within the gut.

      It is located in the submucosal layer on the inner surface of the muscularis externa.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      16.4
      Seconds
  • Question 2 - 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: It is a Gram-positive bacteria

      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
      27.7
      Seconds
  • Question 3 - Which of the following muscles is NOT involved in depression of the mandible:...

    Incorrect

    • Which of the following muscles is NOT involved in depression of the mandible:

      Your Answer: Lateral pterygoid

      Correct Answer: Masseter

      Explanation:

      Depression of the mandible is generated by the digastric, geniohyoid, mylohyoid and lateral pterygoid muscles on both side, assisted by gravity. The lateral pterygoid muscles are also involved as this movement also involves protraction of the mandible. The masseter muscle is a powerful elevator of the mandible.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      21.4
      Seconds
  • Question 4 - Which of the following nerves is most important for eversion of the foot:...

    Incorrect

    • Which of the following nerves is most important for eversion of the foot:

      Your Answer: Deep fibular nerve

      Correct Answer: Superficial fibular nerve

      Explanation:

      Eversion of the foot is primarily produced by the fibularis longus and fibularis brevis, both innervated by the superficial fibular nerve. The fibularis tertius, innervated by the deep fibular nerve, also assists in this action.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      16.6
      Seconds
  • Question 5 - A 50-year-old man presents with headaches, lethargy, hypertension, and electrolyte disturbance. A...

    Correct

    • A 50-year-old man presents with headaches, lethargy, hypertension, and electrolyte disturbance. A diagnosis of primary hyperaldosteronism is made.

      Which biochemical pictures would best support this diagnosis?

      Your Answer: Hypokalaemic metabolic alkalosis

      Explanation:

      When there are excessive levels of aldosterone outside of the renin-angiotensin axis, primary hyperaldosteronism occurs. High renin levels will lead to secondary hyperaldosteronism.

      The classical presentation of hyperaldosteronism when symptoms are present include:
      Hypokalaemia
      Metabolic alkalosis
      Hypertension
      Normal or slightly raised sodium levels

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      8.9
      Seconds
  • Question 6 - Insulin is produced by which of the following pancreatic cells: ...

    Correct

    • Insulin is produced by which of the following pancreatic cells:

      Your Answer: β cells

      Explanation:

      Insulin is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas. Insulin is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds. Proinsulin is synthesised as a single-chain peptide. Within storage granules, a connecting peptide (C peptide) is removed by proteases to yield insulin. Insulin release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin, but most output is driven by the rise in plasma glucose concentration that occurs after a meal. The effects of insulin are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      12
      Seconds
  • Question 7 - Which of the following best describes a natural killer cell: ...

    Correct

    • Which of the following best describes a natural killer cell:

      Your Answer: A large granular lymphocyte that kills by inducing target cell apoptosis.

      Explanation:

      Natural killer (NK) cells are cytotoxic CD8 positive cells that lack the T-cell receptor. They are large cells with cytoplasmic granules. NK cells are designed to kill target cells that have a low level of expression of HLA class I molecules, such as may occur during viral infection or on a malignant cell. NK cells do this by displaying several receptors for HLA molecules on their surface. When HLA is expressed on the target cell these deliver an inhibitory signal into the NK cell. When HLA molecules are absent on the target cell this inhibitory signal is lost and the NK cell can then kill its target. In addition, NK cells display antibody-dependent cell-mediated cytotoxicity. In this, antibody binds to antigen on the surface of the target cell and then NK cells bind to the Fc portion of the bound antibody and kill the target cell.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      149.1
      Seconds
  • Question 8 - A 77 year old lady presents to ED with her left leg shortened...

    Incorrect

    • A 77 year old lady presents to ED with her left leg shortened and externally rotated following slipping and falling on a wet bathroom floor. There is an intracapsular fracture of the neck of femur seen on imaging studies. She is at risk of avascular necrosis of the head of femur.

      This is caused by lack of blood supply from which of these arteries?

      Your Answer: Superior gluteal artery

      Correct Answer: Medial circumflex artery

      Explanation:

      The primary blood supply to the head of the femur is from branches of the medial femoral circumflex artery.

      The superior and inferior gluteal arteries supply the hip joint but not the head of femur.

      The lateral circumflex artery anastomoses with the medial femoral circumflex artery and assists in supplying the head of femur.

      The obturator artery is an important source of blood supply in children up to about 8 years. It gives rise to the artery of the head of femur which runs in the ligamentum teres and is insufficient to supply the head of femur in adults.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      212.2
      Seconds
  • Question 9 - A 25-year-old guy who has had a knee-high plaster cast on his left...

    Correct

    • A 25-year-old guy who has had a knee-high plaster cast on his left leg for the past 5 weeks arrives at the emergency department complaining of numbness on the dorsum of his left foot and an inability to dorsiflex or evert his foot. You know that his symptoms are due to fibular nerve compression. Where is the fibular nerve located?

      Your Answer: Neck of fibula

      Explanation:

      Dorsiflexion and eversion of the foot are innervated by the deep fibular nerve and the superficial fibular nerve, respectively.

      The common fibular nerve runs obliquely downward along the lateral border of the popliteal fossa (medial to the biceps femoris) before branching at the neck of the fibula.

      Thus, it is prone to being affected during an impact injury or fracture to the bone or leg. Casts that are placed too high can also compress the fibular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      15.5
      Seconds
  • Question 10 - A 28 year old man presents with abdominal pain and constipation, and bloods...

    Correct

    • A 28 year old man presents with abdominal pain and constipation, and bloods show hypocalcaemia. Which of the following hormones is increased as a result of hypocalcaemia?

      Your Answer: Parathyroid hormone

      Explanation:

      Parathyroid hormone (PTH), also called parathormone or parathyrin, is a peptide hormone that is secreted by the parathyroid glands, which lie immediately behind the thyroid gland. In particular, this hormone is made by chief cells. It regulates the serum calcium concentration through its effects on bone, kidney, and intestine. This hormone is primarily released in response to decreasing plasma Ca2+ concentration and it serves to increase plasma calcium levels and decrease plasma phosphate levels.
      PTH activates Ca2+entry channels in the apical membrane and the Ca2+ATPase pump in the basolateral membrane and as a result, increases calcium reabsorption in the distal tubule of the nephron. It inhibits reabsorption of phosphate and this increases its excretion by in the proximal tubule of the nephron.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      12.8
      Seconds
  • Question 11 - What is nimodipine used predominantly in the treatment of? ...

    Correct

    • What is nimodipine used predominantly in the treatment of?

      Your Answer: Prevention and treatment of vascular spasm following subarachnoid haemorrhage

      Explanation:

      Nimodipine is a smooth muscle relaxant that is related to nifedipine, but the effects preferentially act on cerebral arteries. It is exclusively used for the prevention and treatment of vascular spasm after an aneurysmal subarachnoid haemorrhage.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      24.9
      Seconds
  • Question 12 - Which of the following is NOT a contraindication to treatment with aspirin at...

    Correct

    • Which of the following is NOT a contraindication to treatment with aspirin at analgesic doses:

      Your Answer: Myasthenia gravis

      Explanation:

      Aspirin (at analgesic doses) is contraindicated in:
      People with a history of true hypersensitivity to aspirin or salicylates (symptoms of hypersensitivity to aspirin or salicylates include bronchospasm, urticaria, angioedema, and vasomotor rhinitis)
      People with active or previous peptic ulceration
      People with haemophilia or another bleeding disorder
      Children younger than 16 years of age (risk of Reye’s syndrome)
      People with severe cardiac failure
      People with severe hepatic impairment
      People with severe renal impairment

      N.B. Owing to an association with Reye’s syndrome, aspirin-containing preparations should not be given to children under 16 years, unless specifically indicated, e.g. for Kawasaki disease.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      8.6
      Seconds
  • Question 13 - You've been summoned to the resuscitation area to assist a patient who is...

    Incorrect

    • You've been summoned to the resuscitation area to assist a patient who is having a seizure. As part of the treatment protocol, a benzodiazepine dose is given.

      Which of the following statements about the use of benzodiazepines in seizures is correct?

      Your Answer: IV diazepam is the first-line drug

      Correct Answer: Lorazepam can be given by the rectal route

      Explanation:

      A single dose of IV benzodiazepine will terminate the seizure in 60 to 80 percent of patients who present with seizures.

      Because benzodiazepines are lipid-soluble, they cross the blood-brain barrier quickly. This explains their quick onset of action.

      As a first-line treatment, IV lorazepam should be given. If IV lorazepam is not available, IV diazepam can be used instead, and buccal midazolam can be used if intravenous access cannot be established quickly. Lorazepam can be administered via the rectal route, but it is less reliable and has a lower absorption rate and bioavailability.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      17.7
      Seconds
  • Question 14 - A patient with abdominal pain, vomiting and bloody diarrhoea develops a low platelet...

    Incorrect

    • A patient with abdominal pain, vomiting and bloody diarrhoea develops a low platelet count and deranged renal function. A diagnosis of haemolytic uraemic syndrome is made.
      Which of the following organisms is a recognised cause of haemolytic uraemic syndrome? Select ONE answer only.

      Your Answer: Legionella pneumophila

      Correct Answer: Escherichia coli

      Explanation:

      E.Colistrain 0157 causes enterohaemorrhagic diarrhoea and can be followed by haemolytic uraemic syndrome (renal failure, haemolytic anaemia and thrombocytopenia).

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      28.8
      Seconds
  • Question 15 - A 65-year-old man complains of severe vertigo, nausea, and tinnitus. Upon presenting himself...

    Correct

    • A 65-year-old man complains of severe vertigo, nausea, and tinnitus. Upon presenting himself to the emergency room, it was observed that he is exhibiting ataxia, right-sided loss of pain and temperature sense on the face, and left-sided sensory loss to the body. An MRI and CT scan was ordered and the results showed that he is suffering from a right-sided stroke.

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

      Your Answer: Basilar artery

      Explanation:

      The lateral pontine syndrome occurs due to occlusion of perforating branches of the basilar and anterior inferior cerebellar (AICA) arteries. It is also known as Marie-Foix syndrome or Marie-Foix-Alajouanine syndrome. It is considered one of the brainstem stroke syndromes of the lateral aspect of the pons.

      It is characterized by ipsilateral limb ataxia, loss of pain and temperature sensation of the face, facial weakness, hearing loss, vertigo and nystagmus, hemiplegia/hemiparesis, and loss of pain and temperature sensation.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      23.5
      Seconds
  • Question 16 - On which of the following is preload primarily dependent? ...

    Correct

    • On which of the following is preload primarily dependent?

      Your Answer: End-diastolic volume

      Explanation:

      Preload refers to the initial stretching of the cardiac myocytes before contraction. It is therefore related to muscle sarcomere length. The sarcomere length cannot be determined in the intact heart, and so, other indices of preload are used, like ventricular end-diastolic volume or pressure. The end-diastolic pressure and volume of the ventricles increase when venous return to the heart is increased, and this stretches the sarcomeres, which increase their preload.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      20.1
      Seconds
  • Question 17 - 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: 2 nd -degree AV block

      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
      46
      Seconds
  • Question 18 - Due to a traffic accident, a male patient was unable to lift his...

    Correct

    • Due to a traffic accident, a male patient was unable to lift his arm, indicating an injury at the glenohumeral joint. Based on the patient’s current condition, which nerve or nerves are may likely damaged?

      Your Answer: Axillary and suprascapular nerve

      Explanation:

      A suprascapular nerve injury causes numbness in the shoulder, as well as weakness in abduction and external rotation.

      Damage to the axillary nerve can result in shoulder or arm muscle weakness, as well as difficulty lifting the arm. This is because the deltoid and supraspinatus muscles, which are innervated by the axillary and suprascapular nerves, are responsible for abduction of the arm at the shoulder joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.5
      Seconds
  • Question 19 - A 63-year-old man presents with severe abdominal pain and vomiting of blood. An...

    Correct

    • A 63-year-old man presents with severe abdominal pain and vomiting of blood. An endoscopy was performed and a peptic ulcer was found to have eroded into an artery nearby.

      Which of the following most likely describes the location of the ulcer?

      Your Answer: The posterior duodenum

      Explanation:

      The most common cause of upper gastrointestinal bleeding is peptic ulcer disease, particularly gastric and duodenal ulcers. Duodenal ulcers are most commonly associated with bleeding compared with gastric ulcers. Posterior duodenal ulcers are considered to be the most likely to cause severe bleeding because of its proximity to the branches of the gastroduodenal artery (GDA).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      9.1
      Seconds
  • Question 20 - Intrinsic factor is secreted by which of the following cell types in the...

    Incorrect

    • Intrinsic factor is secreted by which of the following cell types in the stomach:

      Your Answer: Principal cells

      Correct Answer: Parietal cells

      Explanation:

      Intrinsic factor is essential for the absorption of the small amounts of vitamin B12 normally present in the diet from the terminal ileum. The parietal cells of the stomach produce intrinsic factor, and following a gastrectomy, the absorption of vitamin B12 will be markedly reduced, and a deficiency state will exist.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      16.1
      Seconds
  • Question 21 - A patient suffers a lower limb fracture that causes damage to the nerve...

    Correct

    • A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus brevis.
      Peroneus brevis receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Superficial peroneal nerve

      Explanation:

      Peroneus brevis is innervated by the superficial peroneal nerve.
      Peroneus longus is innervated by the superficial peroneal nerve.
      Peroneus tertius is innervated by the deep peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      25.9
      Seconds
  • Question 22 - Identify the type of graph described below:

    A graph that is a useful summary...

    Correct

    • Identify the type of graph described below:

      A graph that is a useful summary of a set of bivariate data (two variables), usually drawn before working out a linear correlation coefficient or fitting a regression line.

      Your Answer: Scatterplot

      Explanation:

      A scatterplot is a useful summary of a set of bivariate data (two variables), usually drawn before working out a linear correlation coefficient or fitting a regression line. It gives a good visual picture of the relationship between the two variables, and aids the interpretation of the correlation coefficient or regression model. Each unit contributes one point to the scatterplot, on which points are plotted but not joined. The resulting pattern indicates the type and strength of the relationship between the two variables.

    • This question is part of the following fields:

      • Evidence Based Medicine
      12.8
      Seconds
  • Question 23 - A 67-year-old man complains of chest pain and goes to the emergency room....

    Incorrect

    • A 67-year-old man complains of chest pain and goes to the emergency room. He takes several medications, including amiodarone.

      Which of the following is amiodarone mechanism of action?

      Your Answer: Inhibits the Na/K ATPase in cardiac myocytes

      Correct Answer: Blocks Na + and K + channels and beta-adrenoreceptors in the heart

      Explanation:

      Amiodarone is an anti-arrhythmic medication that can be used to treat both ventricular and atrial arrhythmias. It’s a class III anti-arrhythmic that works by blocking a variety of channels, including Na+ and K+ channels, as well as beta-adrenoreceptors. As a result, it slows conduction through the SA and AV nodes and prolongs phase 3 of the cardiac action potential (slowing repolarisation).

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      20.5
      Seconds
  • Question 24 - A 40-year-old woman presents with retrosternal central chest pain that she has been...

    Correct

    • A 40-year-old woman presents with retrosternal central chest pain that she has been complaining about for the past two days. Upon deep inspiration and while lying flat, the pain worsens but relieved by sitting forwards. The pain radiates to both of her shoulders. The result of her ECG shows widespread concave ST-elevation and PR depression. A diagnosis of pericarditis is suspected.

      Which of the following nerves is responsible for the pattern of her pain?

      Your Answer: Phrenic nerve

      Explanation:

      Pericarditis is inflammation of the pericardial sac and is the most common pathologic process involving the pericardium. Frequently, pericardial inflammation can be accompanied by increased fluid accumulation within the pericardial sac forming a pericardial effusion, which may be serous, hemorrhagic or purulent depending on aetiology.

      The classic presentation is with chest pain that is central, severe, pleuritic (worse on deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      21.3
      Seconds
  • Question 25 - A patient presents to ED complaining of pins and needles over the lateral...

    Incorrect

    • A patient presents to ED complaining of pins and needles over the lateral three and a half digits. You suspect carpal tunnel syndrome. Which of the following clinical features would you most expect to see on examination:

      Your Answer: Inability to flex the interphalangeal joint of the thumb

      Correct Answer: Inability to touch the pad of the little finger with the thumb

      Explanation:

      Compression of the median nerve in the carpal tunnel will result in weakness and atrophy of the thenar muscles – resulting in weakness of opposition, abduction and flexion of the thumb at the metacarpophalangeal joint and anaesthesia or paraesthesia over the distribution of the palmar digital branch of the median nerve (skin over the palmar surface and fingertips of the lateral three and a half digits). The adductor pollicis muscle is innervated by the ulnar nerve, and abduction of the fingers is produced by the interossei, also innervated by the ulnar nerve. Flexion of the interphalangeal joint of the thumb is produced by the flexor pollicis longus, and flexion of the distal interphalangeal joint of the index finger is produced by the flexor digitorum profundus. Median nerve injury at the wrist will not affect the long flexors of the forearm as these are innervated by the anterior interosseous nerve which arises in the proximal forearm.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      95.7
      Seconds
  • Question 26 - What is the main mechanism of action of metoclopramide: ...

    Correct

    • What is the main mechanism of action of metoclopramide:

      Your Answer: Dopamine antagonist

      Explanation:

      Metoclopramide is a dopamine-receptor antagonist. Blockade of inhibitory dopamine receptors in the GI tract may allow stimulatory actions of ACh at muscarinic synapses to predominate. Metoclopramide also blocks dopamine D2-receptors within the chemoreceptor trigger zone (CTZ). At high doses, it is also thought to have some 5-HT3antagonist activity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      5.8
      Seconds
  • Question 27 - The following are all examples of type I hypersensitivity EXCEPT for: ...

    Incorrect

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

      Your Answer: Asthma

      Correct Answer: Contact dermatitis

      Explanation:

      Examples of type I reactions include:
      Allergic rhinitis
      Allergic conjunctivitis
      Allergic asthma
      Systemic anaphylaxis
      Angioedema
      Urticaria
      Penicillin allergy

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      12.3
      Seconds
  • Question 28 - A 29-year-old man has been complaining about his recent headaches. Detailed history was...

    Correct

    • A 29-year-old man has been complaining about his recent headaches. Detailed history was taken and a neurological examination was performed.

      Which of the following cranial nerves is correctly paired with its lesion?

      Your Answer: The oculomotor nerve: the eye appears to look ‘down and out’

      Explanation:

      The following are the lesions of the cranial nerves:
      1. Olfactory nerve (I)
      Reduced taste and smell, but not to ammonia which stimulates the pain fibres carried in the trigeminal nerve

      2. Optic nerve (II)
      Manifested by visual field defects, pupillary abnormalities, optic neuritis, optic atrophy, papilledema

      3. Oculomotor nerve (III)
      A fixed, dilated pupil which doesn’t accommodate, ptosis, complete internal ophthalmoplegia (masked by ptosis), unopposed lateral rectus causes outward deviation of the eye. If the ocular sympathetic fibres are also affected behind the orbit, the pupil will be fixed but not dilated.

      4. Trochlear nerve (IV)
      Diplopia due to weakness of downward and inward eye movement. The most common cause of a pure vertical diplopia. The patient tends to compensate by tilting the head away from the affected side.

      5. Trigeminal nerve (V)
      Reduced sensation or dysesthesia over the affected area. Weakness of jaw clenching and side-to-side movement. If there is a lower motor neuron (LMN) lesion, the jaw deviates to the weak side when the mouth is opened. There may be fasciculation of temporalis and masseter.

      6. Abducens nerve (VI)
      Inability to look laterally. The eye is deviated medially because of unopposed action of the medial rectus muscle.

      7. Facial nerve (VII)
      Facial weakness. In an LMN lesion the forehead is paralysed – the final common pathway to the muscles is destroyed; whereas the upper facial muscles are partially spared in an upper motor neurone (UMN) lesion because of alternative pathways in the brainstem. There appear to be different pathways for voluntary and emotional movement. CVAs usually weaken voluntary movement, often sparing involuntary movements (e.g., spontaneous smiling). The much rarer selective loss of emotional movement is called mimic paralysis and is usually due to a frontal or thalamic lesion.

      8. Vestibulocochlear nerve (VIII)
      Unilateral sensorineural deafness, tinnitus. Slow-growing lesions seldom present with vestibular symptoms as compensation has time to occur.

      9. Glossopharyngeal nerve (IX)
      Unilateral lesions do not cause any deficit because of bilateral corticobulbar connections. Bilateral lesions result in pseudobulbar palsy. These nerves are closely interlinked.

      10. Vagus nerve (X)
      Palatal weakness can cause ‘nasal speech’ and nasal regurgitation of food. The palate moves asymmetrically when the patient says ‘ahh’. Recurrent nerve palsy results in hoarseness, loss of volume and ‘bovine cough’.

      11. Accessory nerve (XI)
      Weakness and wasting of sternocleidomastoid and trapezius muscles

      12.Hypoglossal nerve (XII)
      An LMN lesion produces wasting of the ipsilateral side of the tongue, with fasciculation; and on attempted protrusion the tongue deviates towards the affected side, but the tongue deviates away from the side of a central lesion.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      47.7
      Seconds
  • Question 29 - A 71-year-old patient has been diagnosed with a dopamine-secreting neuroendocrine tumour.

    Which of the...

    Correct

    • A 71-year-old patient has been diagnosed with a dopamine-secreting neuroendocrine tumour.

      Which of the following statements about dopamine is correct?

      Your Answer: It inhibits prolactin release from the anterior pituitary

      Explanation:

      Dopamine is a neurotransmitter and amine hormone that is derived from the amino acid tyrosine. It is made in a number of places throughout the human body, both inside and outside the central nervous system. The adrenal medulla, dopamine neurons in the arcuate nucleus of the hypothalamus, the substantia nigra, and other areas of the brain produce dopamine.

      The tuberoinfundibular pathway refers to the dopamine neurons in the arcuate nucleus of the hypothalamus’ tubeal region. Dopamine is discharged into the hypothalamo-hypophyseal portal system from these neurons’ neurosecretory terminals at the median eminence.

      The major function of dopamine produced from the hypothalamus is to suppress prolactin production from the anterior pituitary, and it is released in reaction to excessive levels of prolactin secretion. Modulation of motor-control centres and activation of reward centres are two more crucial activities of the brain.
      Dopamine-secreting cells can also be found in other areas of the body, where they perform mostly paracrine functions (acting on nearby cells).

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      17.2
      Seconds
  • Question 30 - Which of the following is NOT a typical clinical feature of diabetic ketoacidosis:...

    Correct

    • Which of the following is NOT a typical clinical feature of diabetic ketoacidosis:

      Your Answer: Cheyne–Stokes respiration

      Explanation:

      Clinical features of DKA:
      Symptoms: Polyuria, polydipsia, thirst, lethargy, weight loss, nausea, vomiting, anorexia, abdominal pain, dehydration, headache, altered mental state
      Signs: Dry mucous membranes, ketotic breath, tachycardia, hypotension, Kussmaul breathing, focal signs of precipitant e.g. infection

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      6.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Gastrointestinal Physiology (1/1) 100%
Physiology (7/8) 88%
Microbiology (0/2) 0%
Specific Pathogen Groups (0/2) 0%
Anatomy (7/11) 64%
Head And Neck (0/1) 0%
Lower Limb (2/4) 50%
Endocrine Physiology (2/2) 100%
Endocrine (3/3) 100%
Immune Responses (1/2) 50%
Pathology (1/2) 50%
Cardiovascular (2/2) 100%
Pharmacology (3/6) 50%
Central Nervous System (4/4) 100%
CNS Pharmacology (0/1) 0%
Cardiovascular Pharmacology (0/2) 0%
Upper Limb (1/2) 50%
Abdomen And Pelvis (1/1) 100%
Gastrointestinal (0/1) 0%
Evidence Based Medicine (1/1) 100%
Thorax (1/1) 100%
Passmed