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Question 1
Incorrect
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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-9
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.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 2
Incorrect
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A 36 year old man who is overweight with a history of gout, presents to emergency room with an acutely painful big toe which is red, hot and swollen. However, he is apyrexic and otherwise systemically well. He has been diagnosed with acute gout. The most appropriate first line treatment for him is which of the following?
Your Answer: Intraarticular corticosteroids
Correct Answer: NSAIDs
Explanation:The first line treatment for acute gout includes NSAIDs like diclofenac, indomethacin or naproxen. In patients in whom NSAIDs are contraindicated, not tolerated or ineffective, colchicine is an alternative. In those who cannot tolerate or who are resistant to NSAIDs and colchicine, oral or parenteral corticosteroids are an effective alternative. In acute monoarticular gout, intra-articular injection of a corticosteroid can be used occasionally. In acute gout. allopurinol is not used in the actual treatment, but its use should be continued during an acute attack if the patient is already established on long term therapy.
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This question is part of the following fields:
- Musculoskeletal
- Pharmacology
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Question 3
Incorrect
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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 Streptococcus pneumoniae
Correct Answer: Hereditary angioedema
Explanation:C1-inhibitor deficiency is the cause of hereditary angioedema not C3 deficiency,
All the other statements are correct
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 4
Incorrect
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A 39-year-old man with a long history of depression presents after intentionally overdoing his heart medication. Verapamil immediate-release 240 mg is the tablet he takes for this condition, he says. He took the pills about 30 minutes ago, but his wife discovered him right away and rushed him to the emergency room.
Which of the following is a verapamil toxicity?Your Answer: Coronary vasoconstriction
Correct Answer: Negative inotropy
Explanation:Overdosing on calcium-channel blockers should always be taken seriously and regarded as potentially fatal. Verapamil and diltiazem are the two most lethal calcium-channel blockers in overdose. These work by binding the alpha-1 subunit of L-type calcium channels, preventing calcium from entering the cell. In cardiac myocytes, vascular smooth muscle cells, and islet beta-cells, these channels play an important role.
The following summarises the toxicity of calcium-channel blockers:
Cardiac effects
Vascular smooth muscle tone affects
Metabolic effects
Excessive negative inotropy: myocardial depression
Negative chronotropy: sinus bradycardia
Negative dromotropy: atrioventricular node blockade
Decreased afterload
Systemic hypotension
Coronary vasodilation
Hypoinsulinaemia
Calcium channel blocker-induced insulin resistance -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 5
Incorrect
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A 30-year-old carpenter presented to the emergency room with a laceration of his upper volar forearm. Upon further exploration and observation, it was revealed that the nerve that innervates the pronator teres muscle has been damaged.
Which of the following nerves is most likely damaged in the case?Your Answer: The musculocutaneous nerve
Correct Answer: The median nerve
Explanation:Pronator teres syndrome (PTS) is caused by a compression of the median nerve (MN) by the pronator teres (PT) muscle in the forearm.
The median nerve, C6 and C7, innervates the pronator teres.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 6
Incorrect
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Which of the following is most likely to cause a homonymous hemianopia:
Your Answer: Pituitary adenoma
Correct Answer: Posterior cerebral artery stroke
Explanation:A posterior cerebral stroke will most likely result in a contralateral homonymous hemianopia with macular sparing.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 7
Incorrect
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Which of the following is NOT a typical cerebellar sign:
Your Answer: Nystagmus
Correct Answer: Hypertonia
Explanation:Hypotonia means decreased muscle tone. It can be a condition on its own, called benign congenital hypotonia, or it can be indicative of another problem where there is progressive loss of muscle tone, such as muscular dystrophy or cerebral palsy. It is usually detected during infancy. Hypotonia is characteristic of cerebellar dysfunction.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 8
Incorrect
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Which of the following acts to inhibit antidiuretic hormone (ADH) release from the posterior pituitary:
Your Answer: Adrenaline
Correct Answer: Atrial natriuretic peptide
Explanation:ADH release is inhibited by low plasma osmolality, alcohol, caffeine, glucocorticoids and atrial natriuretic peptide (ANP).
ADH release is stimulated primarily by raised plasma osmolality detected by osmoreceptors in the anterior hypothalamus. Other factors that increase ADH release include: extracellular fluid volume depletion, angiotensin II, nausea, pain, stress, exercise, emotion, hypoglycaemia.
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This question is part of the following fields:
- Endocrine
- Physiology
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Question 9
Correct
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What is the primary function of collagen in wound healing?
Your Answer: Strength and support
Explanation:Key elements of the maturation stage include collagen cross-linking, collagen remodelling, wound contraction, and repigmentation. The tensile strength of the wound is directly proportional to the amount of collagen present. Numerous types of collagen have been identified; types I and III predominate in the skin and aponeurotic layers. Initially, a triple helix (tropocollagen) is formed by three protein chains; two are identical alpha-1 protein chains, and the third is an alpha-2 protein.
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This question is part of the following fields:
- Pathology
- Wound Healing
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Question 10
Incorrect
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A 54-year-old woman has been visiting her GP with symptoms of tiredness, muscle weakness and headaches. She is known to be hypertensive and takes amlodipine to control this. Her blood results today show that her potassium level is low at 3.0 mmol/L, and her sodium level is slightly elevated at 146 mmol/L.
Which of the following is the SINGLE most appropriate INITIAL investigation?Your Answer: Plasma ACTH levels
Correct Answer: Plasma renin and aldosterone levels
Explanation:Primary hyperaldosteronism occurs when there are excessive levels of aldosterone independent of the renin-angiotensin axis. Secondary hyperaldosteronism occurs due to high renin levels.
The causes of primary hyperaldosteronism include:
Adrenal adenoma (Conn’s syndrome) – the most common cause of hyperaldosteronism (,80% of all cases). These are usually unilateral and solitary and are more common in women.
Adrenal hyperplasia – this accounts for ,15% of all cases. Usually, bilateral adrenal hyperplasia (BAH) but can be unilateral rarely. More common in men than women.
Adrenal cancer – a rare diagnosis but essential not to miss
Familial aldosteronism – a rare group of inherited conditions affecting the adrenal glands
The causes of secondary hyperaldosteronism include:
Drugs – diuretics
Obstructive renal artery disease – renal artery stenosis and atheroma
Renal vasoconstriction – occurs in accelerated hypertension
Oedematous disorders – heart failure, cirrhosis and nephrotic syndrome
Patients are often asymptomatic. When clinical features are present, the classically described presentation of hyperaldosteronism is with:
Hypertension
Hypokalaemia
Metabolic alkalosis
Sodium levels can be normal or slightly raised
Other, less common, clinical features include:
Lethargy
Headaches
Muscle weakness (from persistent hypokalaemia)
Polyuria and polydipsia
Intermittent paraesthesia
Tetany and paralysis (rare)
Often the earliest sign of hyperaldosteronism is from aberrant urea and electrolytes showing hypokalaemia and mild hypernatraemia. If the patient is taking diuretics, and the diagnosis is suspected, these should be repeated after the patient has taken off diuretics.
If the diagnosis is suspected, plasma renin and aldosterone levels should be checked. Low renin and high aldosterone levels (with a raised aldosterone: renin ratio) is suggestive of primary aldosteronism.
If the renin: aldosterone ratio is high, then the effect of posture on renin, aldosterone and cortisol can be investigated to provide further information about the underlying cause of primary hyperaldosteronism. Levels should be measured lying at 9 am and standing at noon:
If aldosterone and cortisol levels fall on standing, this is suggestive of an ACTH dependent cause, e.g. adrenal adenoma (Conn’s syndrome)
If aldosterone levels rise and cortisol levels fall on standing, this is suggestive of an angiotensin-II dependent cause, e.g. BAH
Other investigations that can help to distinguish between an adrenal adenoma and adrenal hyperplasia include:
CT scan
MRI scan
Selective adrenal venous sampling -
This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 11
Incorrect
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A patient with diplopia is found to have eye deviation downwards and outwards. The likely nerves that are affected are:
Your Answer: Optic nerve
Correct Answer: Oculomotor nerve
Explanation:The results of an oculomotor (CN III) nerve palsy are a depressed and abducted (down and out) eye, ptosis, diplopia, and a fixed and dilated pupil.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 12
Correct
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Which of the following is NOT an effect of cytokine activity:
Your Answer: Opsonisation of bacteria for phagocytosis
Explanation:Cytokines are a family of chemical messengers, secreted by leucocytes, that act over short distances by binding specific receptors on target cell surfaces. They include: interleukins (act between leucocytes), interferons (inhibit replication of viruses within cells and activate macrophages and natural killer cells), growth factors, and tumour necrosis factors (kill tumour cells). Effects include: induction of fever and acute phase response, stimulation of leucocyte differentiation and maturation, leucocyte recruitment and activation and increased antibody production.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 13
Incorrect
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A 20-year-old male patient lives in a travelling community and has never received any vaccinations. He presents to you with fever.
Which of these statements concerning indications and contraindications for vaccination is FALSE?
Your Answer: Vaccination is contraindicated if there has been a confirmed anaphylactic reaction to a previous dose of a vaccine containing the same antigens
Correct Answer: Premature infants should have the their immunisation schedule adjusted for gestational age
Explanation:All vaccines are contraindicated in individuals with:
A confirmed anaphylactic reaction to a previous dose of the vaccine or a vaccine containing the same antigens.
A confirmed anaphylactic reaction to a component in the vaccine e.g. neomycinLive attenuated vaccines are contraindicated in pregnancy except in cases where risk of infection is more than the risks of vaccination.
During times of acute febrile illness, vaccination should be avoided.
12 weeks should elapse after a dose of human immunoglobulin before a live vaccine is administered.
The normal times recommended for immunization of full-term babies should also be applied to premature infants and correction for gestational age should NOT be implemented.
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This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 14
Incorrect
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Regarding the resting membrane potential, which of the following statements is CORRECT:
Your Answer: At rest the inside of the cell is positive relative to the outside.
Correct Answer: The resting cell membrane is more permeable to K + ions than to Na + ions.
Explanation:A membrane potential is a property of all cell membranes, but the ability to generate an action potential is only a property of excitable tissues. The resting membrane is more permeable to K+and Cl-than to other ions (and relatively impermeable to Na+); therefore the resting membrane potential is primarily determined by the K+equilibrium potential. At rest the inside of the cell is negative relative to the outside. In most neurones the resting potential has a value of approximately -70 mV.
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This question is part of the following fields:
- Basic Cellular
- Physiology
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Question 15
Incorrect
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A patient with pronounced tremor, muscle contractions, muscle spasms, and slowness of movement is brought in by his family. He has a long history of mental health issues for which he is currently treated with a variety of medications.
Which of the medications listed below is most likely to be the cause of these side effects?Your Answer: Gabapentin
Correct Answer: Haloperidol
Explanation:Acute dyskinesias and dystonic reactions, tardive dyskinesia (rhythmic, involuntary movements of the tongue, face, and jaw), Parkinsonism (tremor, bradykinesia, and rigidity), akinesia, akathisia, and neuroleptic malignant syndrome are all examples of extrapyramidal side effects. They are caused by dopamine depletion or blockade in the basal ganglia; this lack of dopamine frequently mimics idiopathic extrapyramidal pathologies.
The first-generation antipsychotics, which are strong dopamine D2 receptor antagonists, are the drugs most commonly associated with extrapyramidal side effects. Haloperidol and fluphenazine are the two drugs in this class that are most commonly associated with extrapyramidal side effects. Extrapyramidal adverse effects are less common in second-generation antipsychotics (e.g., olanzapine) than in first-generation antipsychotics.
Other drugs are linked to extrapyramidal symptoms as well, but at a lower rate. Some antidepressants, lithium, various anticonvulsants, antiemetics, and, in rare cases, oral contraceptive agents are among them.
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 16
Incorrect
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A 70-year-old patient diagnosed with Cushing's syndrome and has a history of weight gain, hypertension, and easy bruising.
Which of these assertions about Cushing's syndrome is correct?Your Answer: Hypotension is common
Correct Answer: Diagnosis can be confirmed by a dexamethasone suppression test
Explanation:Cushing’s syndrome is a group of symptoms and signs brought on by long-term exposure to high amounts of endogenous or exogenous glucocorticoids.
Iatrogenic corticosteroid injection is the most prevalent cause of Cushing’s syndrome. Cushing’s illness is the second most prevalent cause of Cushing’s syndrome. Cushing’s disease is distinct from Cushing’s syndrome in that it refers to a single cause of the illness, a pituitary adenoma that secretes high quantities of ACTH, which raises cortisol levels.
Because cortisol enhances the vasoconstrictive impact of endogenous adrenaline, patients with Cushing’s syndrome are usually hypertensive.
Hyperglycaemia (due to insulin resistance) rather than hypoglycaemia is a common symptom.
Cortisol levels fluctuate throughout the day, with the greatest levels occurring around 0900 hours and the lowest occurring at 2400 hrs during sleep. The diurnal swing of cortisol levels is lost in Cushing’s syndrome, and levels are greater throughout the 24-hour period. In the morning, levels may be normal, but they may be high at night-time, when they are generally repressed.A dexamethasone suppression test or a 24-hour urine free cortisol collection can both be used to establish the existence of Cushing’s syndrome.
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This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 17
Correct
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Regarding the lacrimal apparatus, which of the following statements is CORRECT:
Your Answer: Lacrimal fluid is drained from the eyeball through the lacrimal punctum.
Explanation:Lacrimal fluid is drained from the eyeball through the lacrimal punctum.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 18
Incorrect
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Which of the following is the most abundant peripheral blood leucocyte:
Your Answer: Basophils
Correct Answer: Neutrophils
Explanation:Neutrophils are the most abundant peripheral blood leucocyte, comprising about 50 – 70% of circulating white cells. Neutrophils have a characteristic dense nucleus consisting of between two and five lobes, and a pale cytoplasm with an irregular outline containing many fine pink-blue or grey-blue granules. The granules are divided into primary, which appear at the promyelocyte stage, and secondary, which appear at the myelocyte stage and predominate in the mature nucleus. Both types of granule are lysosomal in origin; the primary contains myeloperoxidase and other acid hydrolases; the secondary contains lactoferrin, lysozyme and other enzymes. The lifespan of neutrophils in the blood is only 6 – 10 hours. In response to tissue damage, cytokines and complement proteins, neutrophils migrate from the bloodstream to the site of insult within minutes, where they destroy pathogens by phagocytosis.
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 19
Incorrect
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A 60-year-old male presents to the genitourinary clinic with dysuria and urinary frequency complaints. He has a past medical history of benign prostate enlargement, for which he has been taking tamsulosin. There is blood, protein, leucocytes, and nitrites on a urine dipstick. Fresh blood tests were sent, and his estimated GFR is calculated to be >60 ml/minute. A urinary tract infection (UTI) diagnosis is made, and he is prescribed antibiotics. Out of the following, which antibiotic is most appropriate to be prescribed to this patient?
Your Answer: Co-amoxiclav
Correct Answer: Ciprofloxacin
Explanation:URINARY TRACT INFECTIONS IN ADULT MEN
Symptomatic urinary tract infections are much less common in men than in women, and all UTIs
in men are considered complicated UTIs. Men with UTIs should be evaluated for predisposing or
causative factors.Uncomplicated cystitis
- Fosfomycin, oral, 3 g as a single dose.
If fosfomycin is unavailable:
- Nitrofurantoin, oral, 100 mg 6 hourly for 5 days.
Do not use nitrofurantoin or fosfomycin if there is any suspicion of early pyelonephritis as they do
not achieve adequate renal tissue levels.
If there are any factors precluding the use of the above agents, then a beta-lactam should be used.
Options include:
Cefixime 200 mg PO 12 hourly for 7 days
OR
Cefpodoxime 100 mg PO 12 hourly for 7 daysComplicated cystitis
Adults- Ciprofloxacin 500 mg PO 12 hourly
OR - Levofloxacin 750 mg PO once daily
Empiric antibiotic therapy should be changed based upon the bacteria isolated and its
antimicrobial susceptibility.
Treat for a total of 7–14 days -
This question is part of the following fields:
- Infections
- Pharmacology
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Question 20
Incorrect
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Regarding Gaussian sample distribution, which of the following statements is false?
Your Answer: It is symmetrical around its mid-point
Correct Answer: It can be skewed left or right
Explanation:Gaussian distribution, also known as normal distribution, is the most important probability distribution in statistics because it fits many natural phenomena. The normal distribution is a probability function that describes how the values of a variable are distributed. Below are its characteristics:
(1) Bell-shaped and symmetrical about the mean
(2) The mean, median, mode are all equal
(3) The total area under the curve and above the x-axis is equal to 1
(4) It has long tapering tails extending infinitely but never touching the x-axis
(5) It is determined by its parameters: its mean and standard deviation
(6) The standard deviation becomes a more meaningful quality than merely being a measure of dispersionThe mean is the most common measure of central tendency. It is the sum of all observed values divided by the number of observation, and is also known as the ‘average’.
The median is the value that falls in the middle position when the observations are ranked in order from the smallest to the largest. If the number of observations is odd, the median is the middle number. If it is even, the median is the average of the two middle numbers.
The mode is the value that occurs with the greatest frequency in a set of observations, and is commonly used in public health statistics, such as the top 10 causes of mortality.
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This question is part of the following fields:
- Evidence Based Medicine
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Question 21
Incorrect
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Insulin binds to the insulin receptor (IR) on cell surfaces to exert its action. The IR is a very specific transmembrane receptor belonging to the tyrosine kinase receptor class.
One of these also activates the IR:
Your Answer: Pancreatic polypeptide
Correct Answer: IGF-I
Explanation:Insulin receptor (IR), in addition to being activated by insulin, is also activated by IGF-I and IGF-II.
The IR is a dimer with two identical subunits spanning the cell membrane and are connected by a single disulphide bond. The two sub-units include: The alpha chain situated on the exterior of the cell membrane and the beta chain spanning the cell membrane in a single segment.
When insulin is detected, the alpha chains move together folding around the insulin making the beta chains move together, converting them into an active tyrosine kinase. This initiates a phosphorylation cascade increasing the expression of GLUT4 and allowing uptake of glucose by cells.
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This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 22
Incorrect
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Regarding gastric motility and emptying, which of the following statements is CORRECT:
Your Answer: The muscularis externa of the stomach has an additional outer circular smooth muscle layer.
Correct Answer: Gastric emptying is inhibited by the presence of the products of fat digestion in the duodenum.
Explanation:Gastric emptying is decreased by the presence of fats in the duodenum (by stimulating release of cholecystokinin). Mixing of the food with gastric secretions takes place in the distal body and antrum of the stomach where the muscularis externa layer is thicker. The stomach has an additional inner oblique smooth muscle layer (in addition to the inner circular layer and outer longitudinal layer). Gastric emptying is increased by a low gastric pH and decreased by a low duodenal pH.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 23
Incorrect
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Glucagon may be used as an antidote for overdose with which of the following:
Your Answer: Theophylline
Correct Answer: Beta blockers
Explanation:Glucagon is a peptide hormone that is produced and secreted by alpha cells of the islets of Langerhans, which are located in the endocrine portion of the pancreas. The main physiological role of glucagon is to stimulate hepatic glucose output, thereby leading to increases in glycaemia. It provides the major counter-regulatory mechanism to insulin in maintaining glucose homeostasis.
Hypoglycaemia is the principal stimulus for the secretion of glucagon but may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline.
Glucagon then causes:
Glycogenolysis
Gluconeogenesis
Lipolysis in adipose tissue
The secretion of glucagon is also stimulated by:
Adrenaline
Cholecystokinin
Arginine
Alanine
Acetylcholine
The secretion of glucagon is inhibited by:
Insulin
Somatostatin
Increased free fatty acids
Increased urea productionGlycolysis is the metabolic pathway that converts glucose into pyruvate. The free energy released by this process is used to form ATP and NADH. Glycolysis is inhibited by glucagon, and glycolysis and gluconeogenesis are reciprocally regulated so that when one cell pathway is activated, the other is inactive and vice versa.
Glucagon has a minor effect of enhancing lipolysis in adipose tissue. Lipolysis is the breakdown of lipids and involves the hydrolysis of triglycerides into glycerol and free fatty acids. It makes fatty acids available for oxidation.
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This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 24
Correct
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Which law describes the rate of diffusion in a solution?
Your Answer: Fick’s law
Explanation:Fick’s law describes the rate of diffusion in a solution. Fick’s law states that:
Jx = -D A (ΔC / Δx)
Where:
Jx = The amount of substance transferred per unit time
D = Diffusion coefficient of that particular substance
A = Surface area over which diffusion occurs
ΔC = Concentration difference across the membrane
Δx = Distance over which diffusion occurs
The negative sign reflects movement down the concentration gradient -
This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 25
Incorrect
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Regarding airway resistance, which of the following statements is INCORRECT:
Your Answer: Flow through airways is inversely proportional to airway resistance.
Correct Answer: In the lower respiratory tract, airway resistance is mostly determined by the smallest bronchioles.
Explanation:Airway resistance is primarily determined by the airway radius according to Poiseuille’s law, and whether the flow is laminar or turbulent. The major site of airway resistance is the medium-sized bronchi. The smallest airways would seem to offer the highest resistance, but they do not because of their branching parallel arrangement.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 26
Incorrect
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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: Aldosterone
Correct 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
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Question 27
Incorrect
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A range of one standard deviation above and below the mean includes what approximate percentage of the sample values:
Your Answer: 0.72
Correct Answer: 0.68
Explanation:A range of one SD above and below the mean (+/- 1 SD) includes 68.2% of the sample values.
A range of two SD above and below the mean (+/- 2 SD) includes 95.4% of the sample values.
A range of three SD above and below the mean (+/- 3 SD) includes 99.7% of the sample values. -
This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 28
Incorrect
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Which of these organisms is commonly spread by droplet transmission?
Your Answer: Poliovirus
Correct Answer: Neisseria meningitidis
Explanation:Droplets are airborne particles greater than 5 µm in size. Droplet transmission occurs during talking, coughing and sneezing where respiratory droplets are generated.
Examples of organisms transmitted by the droplet route include:
Neisseria meningitidis
Respiratory syncytial virus
Parainfluenza virus
Bordetella pertussis
Influenza virusPoliovirus and Rotavirus are transmitted by the faeco-oral route
Hepatitis B is transmitted by Sexual route
Staphylococcus aureus is transmitted by direct contact
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This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 29
Incorrect
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A dermatological examination on a patient presenting with a skin lesion which shows a solid, well circumscribed, lump measuring 0.8 cm in diameter. Which one of these best describes the lump you have found on examination?
Your Answer:
Correct Answer: Papule
Explanation:Macule— a small patch of skin that is altered in colour, but is not elevated.
Patch — a large area of colour change, with a smooth surface.
Papule— elevated, solid, palpable lesion that is ≤ 1 cm in diameter. They may be solitary or multiple. Papules may be:
Nodule — elevated, solid, palpable lesion > 1 cm usually located primarily in the dermis and subcutis (deeper layers of the skin). The greatest portion of the lesion may be above or beneath the skin surface.
Vesicle — a small blister. It is a circumscribed lesion ≤ 1 cm in diameter that contains liquid (clear, serous or haemorrhagic).
Cyst — papule or nodule that contains fluid or semi-fluid material so is fluctuant
Plaque — a circumscribed, palpable lesion more than 1 cm in diameter; most plaques are elevated.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 30
Incorrect
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The correct statement about the glomerular filtration barrier is which of the following?
Your Answer:
Correct Answer: The basement membrane is negatively charged, restricting filtration of negatively charged molecules.
Explanation:The main factor in determining whether a substance is filtered or not is molecular weight. Molecules < 7 kDa in molecular weight e.g. glucose, amino acids, urea, ions are filtered freely, but larger molecules are increasingly restricted up to 70 kDa, and there is very little filtration for anything above this.
There is further restriction of negatively charged molecules because they are repelled by negative charges, particularly in the basement membrane. Albumin, which has a molecular weight of 69 kDa and is negatively charged, is filtered but only in very small amounts. All of the filtered albumin is reabsorbed in the proximal tubule. Small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. Other than the ultrafiltrate being essentially protein free, it has an otherwise identical composition of plasma. Bowman’s capsule consists of:
– an epithelial lining which consists of a single layer of cells called podocytes
– endothelium which is perforated by pores or fenestrations – this allows plasma components with a molecular weight of < 70 kDa to pass freely. -
This question is part of the following fields:
- Physiology
- Renal
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SESSION STATS - PERFORMANCE PER SPECIALTY
