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  • Question 1 - Which of the following is most likely affected in De Quervain's tenosynovitis? ...

    Incorrect

    • Which of the following is most likely affected in De Quervain's tenosynovitis?

      Your Answer: Extensor pollicis longus

      Correct Answer: Extensor pollicis brevis

      Explanation:

      De Quervain tenosynovitis is named after the Swiss surgeon, Fritz de Quervain, who first described it in 1895. It is a condition which involves tendon entrapment affecting the first dorsal compartment of the wrist. With this condition thickening of the tendon sheaths around the abductor pollicis longus and extensor pollicis brevis develops where the tendons pass in through the fibro-osseous tunnel located along the radial styloid at the distal wrist. Pain is exacerbated by thumb movement and radial and ulnar deviation of the wrist.

      The estimated prevalence of de Quervain tenosynovitis is about 0.5% in men and 1.3% in women with peak prevalence among those in their forties and fifties. It may be seen more commonly in individuals with a history of medial or lateral epicondylitis. Bilateral involvement is often reported in new mothers or child care providers in whom spontaneous resolution typically occurs once lifting of the child is less frequent.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.6
      Seconds
  • Question 2 - What is the effect of activated vitamin D on the renal handling of...

    Correct

    • What is the effect of activated vitamin D on the renal handling of calcium:

      Your Answer: Increases calcium reabsorption in the distal tubule

      Explanation:

      Activated vitamin D acts to:
      GUT:increase calcium and phosphate absorption in the small intestine (the main action)
      KIDNEYS:increase renal calcium reabsorption (in the distal tubule via activation of a basolateral Ca2+ATPase pump), increase renal phosphate reabsorption, inhibit 1-alpha-hydroxylase activity in the kidneys (negative feedback)
      PARATHYROID GLANDS:inhibit PTH secretion from the parathyroid glands

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      36.9
      Seconds
  • Question 3 - 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
      33.9
      Seconds
  • Question 4 - A 52-year-old female visits the Emergency Department complaining of an acute worsening of...

    Correct

    • A 52-year-old female visits the Emergency Department complaining of an acute worsening of her asthma symptoms. A detailed history reveals that she took one of her brother's heart pills without a prescription as she was experiencing palpitations and thought it would cure her. Her shortness of breath was suddenly exacerbated after ingesting this medicine.

      Which one of the following medications has this woman most likely consumed?

      Your Answer: Propranolol

      Explanation:

      Propranolol, like other non-selective beta-blockers, is contraindicated in patients with asthma. These drugs can cause acute bronchospasm, therefore worsening symptoms, especially in high doses. However, there has been some recent evidence that long-term use of selective beta-blockers in mild or moderate asthma patients can be safe.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      15.6
      Seconds
  • Question 5 - As part of his angina treatment, a 68-year-old man is prescribed a beta...

    Correct

    • As part of his angina treatment, a 68-year-old man is prescribed a beta blocker. He starts having nightmares and has trouble sleeping soon after starting the beta-blocker.

      Which of the beta blockers listed below is the most likely to be in his system?

      Your Answer: Propranolol

      Explanation:

      The beta-adrenoceptors in the heart, peripheral vasculature, bronchi, pancreas, and liver are blocked by beta-adrenoceptor blocking drugs (beta blockers).

      Beta blockers come in a wide range of strengths, with the choice largely determined by the disease being treated and the patient’s unique circumstances. The intrinsic sympathomimetic activity, lipid solubility, duration of action, and cardioselectivity of beta blockers all differ.

      Some beta blockers are lipid (lipophilic) soluble, while others are water soluble (hydrophilic). Drugs that are more lipid-soluble are absorbed faster from the gut, undergo more first-pass metabolism, and are eliminated faster. They’re also more likely to get into the brain and cause central effects like insomnia and nightmares. Propranolol, pindolol, labetalol, and metoprolol are examples of lipid-soluble beta blockers. Beta blockers that are water-soluble are less likely to enter the brain and are more resistant to first-pass metabolism. They are excreted by the kidneys, and in renal impairment, dosage reduction is frequently required. Atenolol, nadolol, celiprolol, and sotalol are examples of water-soluble beta blockers.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      30.7
      Seconds
  • Question 6 - The triage nurse asks if you will prescribe a dose of codeine phosphate...

    Correct

    • The triage nurse asks if you will prescribe a dose of codeine phosphate for a patient who is in a lot of pain. You discover that you are unable to prescribe it due to a contra-indication after evaluating the patient.

      The use of codeine phosphate is contraindicated in which of the following situations?

      Your Answer: Age under 12 years

      Explanation:

      Codeine phosphate is a mild opiate that can be used to treat mild to moderate pain when other pain relievers like paracetamol or ibuprofen have failed. It can also be used to treat diarrhoea and coughs that are dry or painful.

      The use of all opioids is contraindicated for the following reasons:
      Respiratory depression (acute)
      Patients who are comatose
      Head injury (opioid analgesics impair pupillary responses, which are crucial for neurological evaluation)
      Intracranial pressure has risen (opioid analgesics interfere with pupillary responses vital for neurological assessment)
      There’s a chance you’ll get paralytic ileus.

      The use of codeine phosphate is contraindicated in the following situations:
      Because of the significant risk of respiratory side effects in children under the age of 12, it is not recommended for children under the age of 12.

      Patients of any age who have been identified as ultra-rapid codeine metabolizers (CYP2D6 ultra-rapid metabolizers)

      Because codeine can pass through breast milk to the baby and because mothers’ ability to metabolise codeine varies greatly, it is especially dangerous in breastfeeding mothers.

      If other painkillers, such as paracetamol or ibuprofen, fail to relieve acute moderate pain in children over the age of 12, codeine should be used. In children with obstructive sleep apnoea who received codeine after tonsillectomy or adenoidectomy, a significant risk of serious and life-threatening adverse reactions has been identified.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      34.4
      Seconds
  • Question 7 - Which of the following is NOT a typical side effect of thiopental sodium:...

    Correct

    • Which of the following is NOT a typical side effect of thiopental sodium:

      Your Answer: Seizures

      Explanation:

      Extravasation of thiopental during injection can lead to tissue damage. Accidental intra-arterial injection causes vasospasm and may lead to thrombosis and tissue necrosis. Other side effects include involuntary muscle movements on induction, cough and laryngospasm, arrhythmias, hypotension, headache and hypersensitivity reactions. Thiopental sodium has anticonvulsant properties and does not cause seizures.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      12.4
      Seconds
  • Question 8 - Which of the following is NOT a notifiable disease: ...

    Incorrect

    • Which of the following is NOT a notifiable disease:

      Your Answer: Whooping cough

      Correct Answer: Chickenpox

      Explanation:

      Chickenpox is not a notifiable disease.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11.8
      Seconds
  • Question 9 - You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble...

    Correct

    • You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble breathing after eating peanuts. Which of the following diagnostic tests will confirm this?

      Your Answer: Mast cell tryptase

      Explanation:

      The concentration of serum tryptase rises in anaphylaxis and anaphylactoid responses.

      Because tryptase is a significant component of mast cell granules, mast cell degranulation causes elevated tryptase levels in the blood.

      Although tryptase levels are not always high during anaphylaxis, it is considered a particular marker.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      25.7
      Seconds
  • Question 10 - The term cardiac output refers to the amount of blood pumped by the...

    Correct

    • The term cardiac output refers to the amount of blood pumped by the heart in one minute. The rate in women is around 5 L/min, whereas in men is somewhat higher, around 5.5 L/min.

      Which of the equations below best describes cardiac output?

      Your Answer: Stroke volume x heart rate

      Explanation:

      Cardiac output (CO) is calculated by multiplying stroke volume (SV) by heart rate (HR):
      CO = HR x SV

      As a result, both stroke volume and heart rate are exactly proportional to cardiac output. There will be an increase in cardiac output if the stroke volume or heart rate increases, and a reduction in cardiac output if the stroke volume or heart rate lowers.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      48.9
      Seconds
  • Question 11 - A 39-year-old man with a long history of depression presents after intentionally overdoing...

    Correct

    • 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.

      At the moment, he is completely symptom-free. When it comes to this type of overdose, how long does it usually take for symptoms to appear?

      Your Answer: 1-2 hours

      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.

      >10 tablets of verapamil (160 mg or 240 mg immediate or sustained-release capsules) or diltiazem can cause serious toxicity (180 mg, 240 mg or 360 mg immediate or sustained-release capsules)

      In children, 1-2 tablets of verapamil or diltiazem (immediate or sustained-release)

      Symptoms usually appear within 1-2 hours of ingestion with standard preparations. However, with slow-release preparations, significant toxicity may take 12-16 hours to manifest, with peak effects occurring after 24 hours.

      The following are the main clinical features of calcium-channel blocker overdose:
      Nausea and vomiting
      Hypotension
      Bradycardia and first-degree heart block
      Myocardial ischaemia and stroke
      Renal failure
      Pulmonary oedema
      Hyperglycaemia

      The following are some of the most important bedside investigations to conduct:
      Blood glucose
      ECG
      Arterial blood gas
      Other investigations that can be helpful include
      Urea & electrolytes
      Chest X-ray (pulmonary oedema)
      Echocardiography

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      14
      Seconds
  • Question 12 - Which of the following statements about lithium treatment is FALSE: ...

    Incorrect

    • Which of the following statements about lithium treatment is FALSE:

      Your Answer: Lithium toxicity occurs at serum lithium concentrations of approximately 1.5 mmol/L and above.

      Correct Answer: Concomitant treatment with NSAIDs decreases serum-lithium concentration.

      Explanation:

      Lithium levels are raised by NSAIDs because renal clearance is reduced. Lithium is a small ion (74 Daltons) with no protein or tissue binding and is therefore amenable to haemodialysis. Lithium is freely distributed throughout total body water with a volume of distribution between 0.6 to 0.9 L/kg, although the volume may be smaller in the elderly, who have less lean body mass and less total body water. Steady-state serum levels are typically reached within five days at the usual oral dose of 1200 to 1800 mg/day. The half-life for lithium is approximately 18 hours in adults and 36 hours in the elderly.
      Lithium is excreted almost entirely by the kidneys and is handled in a manner similar to sodium. Lithium is freely filtered but over 60 percent is then reabsorbed by the proximal tubules.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      33.5
      Seconds
  • Question 13 - Which patient group are most commonly associated with infection with Klebsiella spp: ...

    Correct

    • Which patient group are most commonly associated with infection with Klebsiella spp:

      Your Answer: Hospitalised patients

      Explanation:

      Klebsiella spp. are facultatively anaerobic Gram-negative rods, found in the normal intestinal and respiratory flora. These organisms are usually opportunistic pathogens that cause nosocomial infections, most commonly pneumonia and UTI.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      21.2
      Seconds
  • Question 14 - Antidiuretic hormone (ADH) is synthesised by which of the following: ...

    Correct

    • Antidiuretic hormone (ADH) is synthesised by which of the following:

      Your Answer: Hypothalamus

      Explanation:

      Antidiuretic hormone is synthesised in the hypothalamus and transported to the posterior pituitary within nerve fibres where it is stored in secretory granules. ADH binds V2 receptors on renal principal cells in the late distal tubule and collecting ducts, raising cAMP levels and causing intracellular vesicles to fuse with the apical membrane. In their membrane these vesicles have water channels called aquaporins, which increase the water permeability allowing greater water reabsorption and concentration of urine. Excess levels of ADH results in syndrome of inappropriate ADH secretion (SIADH) characterised by hyponatremia with concomitant hypo-osmolality and high urine osmolality.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      19.4
      Seconds
  • Question 15 - Which of the following best describes digoxin: ...

    Correct

    • Which of the following best describes digoxin:

      Your Answer: A positive inotrope and negative chronotrope

      Explanation:

      Digoxin is a cardiac glycoside used in the treatment of atrial fibrillation and flutter, and congestive cardiac failure. It acts by inhibiting the membrane Na/K ATPase in cardiac myocytes. This raises intracellular sodium concentration and increases intracellular calcium availability indirectly via Na/Ca exchange. The increase in intracellular calcium levels causes an increases the force of myocardial contraction (positive inotrope), and slows the heart rate (negative chronotrope).

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      18
      Seconds
  • Question 16 - A 30-year-old male presents with easy bruising and bleeding gums, feeling very tired...

    Correct

    • A 30-year-old male presents with easy bruising and bleeding gums, feeling very tired lately, and recurrent chest infections over the past few months. He had glandular fever approximately 6 months ago and feels that his symptoms started after that.

      His full blood count today is as follows:
      Hb 6.3 g/dl (11.5-14 g/dl)
      MCV 90 fl (80-100 fl)
      WCC 2.0 x 10 9 /l (4-11 x 10 9 /l)
      Platelets 15 x 10 9 /l (150-450 x 10 9 /l)

      The SINGLE most likely diagnosis is?

      Your Answer: Aplastic anaemia

      Explanation:

      Aplastic anaemia is a life-threatening failure of haemopoiesis characterised by pancytopenia and hypocellular bone marrow. It is rare and patients present with features of recurrent infections secondary to (leukocytopenia), increased bleeding tendency (secondary to thrombocytopenia) and anaemia. In aplastic anaemia, there is damage to the bone marrow and the haematopoietic stems cells leading to pancytopenia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      14.4
      Seconds
  • Question 17 - You review a 37-year-old man with a history of intravenous drug abuse who...

    Correct

    • You review a 37-year-old man with a history of intravenous drug abuse who admits to sharing needles in the past. He has a flu-like illness and a rash. Concerned he may be experiencing an HIV seroconversion illness, you order a test.

      Which of these tests is most reliably used to diagnose HIV at this stage?

      Your Answer: p24 antigen test

      Explanation:

      Serum concentrations of the p24 antigen are usually high in the first few weeks after human immunodeficiency virus (HIV) infection and testing for p24 antigen is therefore a useful way of diagnosing very early infection. P24 is the viral protein that makes up most of the core of the HIV.

      ELISA and other antibody tests, though a very sensitive way of detecting the presence of HIV, cannot be used in the early stages of the disease. This is because of the window period of 6-12 weeks before antibodies are produced. These tests will be negative during a seroconversion illness.

      The ‘rapid HIV test’ is an HIV antibody test. It will also be negative during the ‘window period’ since it takes time for antibodies to be produced. It is called the ‘rapid test’ as it can detect antibodies in blood or saliva much quicker than the other antibody tests and results are often back within 20 minutes.

      CD4 and CD8 counts are usually normal in the early stages of the HIV infection and cannot be used in this case.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      29.6
      Seconds
  • Question 18 - A 60-year-old female has a past medical history of diverticular disease. She now...

    Correct

    • A 60-year-old female has a past medical history of diverticular disease. She now presents in the clinic with crampy abdominal pain. The nurse at the triage suggests prescribing hyoscine butyl bromide to help relieve the abdominal pain. However, after administering this treatment, the patient develops a side-effect to the medication.

      What side-effect of using hyoscine butyl bromide is she MOST likely to develop out of the following?

      Your Answer: Dry mouth

      Explanation:

      Hyoscine butylbromide is an antispasmodic drug that blocks muscarinic receptors and reduces intestinal motility. It is used for gastrointestinal and genitourinary smooth muscle spasms and symptomatic relief of IBS.

      It has the following side-effects:
      1. Constipation
      2. Dizziness
      3. Drowsiness
      4. Dry mouth
      5. Dyspepsia
      6. Flushing
      7. Headache
      8. Nausea and vomiting
      9. Palpitations
      10. Skin reactions
      11. Tachycardia
      12. Urinary disorders
      13. Disorders of vision

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      29.4
      Seconds
  • Question 19 - A 65-year-old man presents with cough and shortness of breath. His sputum is...

    Correct

    • A 65-year-old man presents with cough and shortness of breath. His sputum is rusty in colour and is suffering from a fever. Upon examination, it was noted that he has crackles in the right upper lobe. A chest X-ray showed the presence of a right upper lobe cavitation.

      Among the following microorganisms, which is considered to be mostly associated with a cavitating upper lobe pneumonia?

      Your Answer: Klebsiella pneumoniae

      Explanation:

      Klebsiella pneumoniae is among the most common Gram-negative bacteria encountered by physicians worldwide and accounts for 0.5-5.0% of all cases of pneumonia. This organism can cause extensive pulmonary necrosis and frequent cavitation.

      It is one of the causes that could be suspected when there is cavitatory pneumonia with or without a bulging fissure sign. Often, there can be extensive lobar opacification with air bronchograms.

      A helpful feature which may help to distinguish from pneumococcal pneumonia is that Klebsiella pneumoniae develops cavitation in 30-50% of cases (in comparison, cavitation is rare in pneumococcal pneumonia). This occurs early and progresses quickly.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      21.1
      Seconds
  • Question 20 - Which of the following ions normally has the highest concentration in intracellular fluid: ...

    Correct

    • Which of the following ions normally has the highest concentration in intracellular fluid:

      Your Answer: K +

      Explanation:

      Potassium (K+) is the principal intracellular ion; approximately 4 mmol/L is extracellular (3%) and 140 mmol/L intracellular (97%).

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      6.6
      Seconds
  • Question 21 - All of the following cause bronchoconstriction, EXCEPT for: ...

    Correct

    • All of the following cause bronchoconstriction, EXCEPT for:

      Your Answer: Adrenaline

      Explanation:

      Factors causing bronchoconstriction:

      • Via muscarinic receptors
      • Parasympathetic stimulation
      • Stimulation of irritant receptors
      • Inflammatory mediators e.g. histamine, prostaglandins, leukotrienes
      • Beta-blockers

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      34.4
      Seconds
  • Question 22 - Which of the following best describes a commensal: ...

    Incorrect

    • Which of the following best describes a commensal:

      Your Answer: A organism that is not capable of causing disease

      Correct Answer: An organism that is part of the normal flora

      Explanation:

      A commensal is an organism that is part of the normal flora.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      19
      Seconds
  • Question 23 - Where does angiotensin II directly act on the renal nephron: ...

    Incorrect

    • Where does angiotensin II directly act on the renal nephron:

      Your Answer: Collecting ducts

      Correct Answer: Proximal tubule

      Explanation:

      Angiotensin II acts to directly increase Na+reabsorption from the proximal tubule (by activating Na+/H+antiporters).

    • This question is part of the following fields:

      • Physiology
      • Renal
      47
      Seconds
  • Question 24 - An unrelated medical condition brings a 28-year-old asthmatic man to the Emergency Department....

    Incorrect

    • An unrelated medical condition brings a 28-year-old asthmatic man to the Emergency Department. When you look over his meds, you notice that he is taking Theophylline to help with his asthma.

      Which of the following medicines should you NOT prescribe?

      Your Answer: Amitriptyline

      Correct Answer: Ciprofloxacin

      Explanation:

      Ciprofloxacin is a cytochrome P450 enzyme inhibitor that raises theophylline levels in the blood. As a result, co-prescribing theophylline should be avoided.

      The medicines that typically impact theophylline’s half-life and plasma concentration are listed in the table below:
      Drugs that increase the levels of theophylline in the blood
      Drugs that lower theophylline levels in the blood
      Calcium channel blockers e.g. Verapamil
      Fluconazole
      Cimetidine
      Quinolones, e.g. ciprofloxacin
      Methotrexate
      Barbiturates
      Carbamazepine
      Phenobarbital
      Macrolides, e.g. erythromycin
      Phenytoin (and fosphenytoin)
      Rifampicin
      St. John’s wort

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      15.6
      Seconds
  • Question 25 - Fibrinoid necrosis is typically seen in which of the following: ...

    Correct

    • Fibrinoid necrosis is typically seen in which of the following:

      Your Answer: Malignant hypertension

      Explanation:

      Fibrinoid necrosis occurs in malignant hypertension where increased arterial pressure results in necrosis of smooth muscle wall. Eosinophilic and fibrinous deposits are seen.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      23.2
      Seconds
  • Question 26 - Bordetella pertussis causes which of the following infectious diseases: ...

    Correct

    • Bordetella pertussis causes which of the following infectious diseases:

      Your Answer: Whooping cough

      Explanation:

      Bordetella pertussis causes whooping cough. Acute bronchiolitis is typically caused by respiratory syncytial virus. Parainfluenza virus is the most common cause of croup. Acute epiglottitis is usually caused by an infection with Haemophilus influenzae type b (Hib) bacteria. The common cold may be caused by a number of viruses including rhinovirus and coronavirus.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      4.9
      Seconds
  • Question 27 - All of the following are indications for beta-blockers EXCEPT for: ...

    Correct

    • All of the following are indications for beta-blockers EXCEPT for:

      Your Answer: Prinzmetal's angina

      Explanation:

      Beta-blockers are contraindicated in Prinzmetal’s angina.Beta-blockers may be indicated in:HypertensionPheochromocytoma (only with an alpha-blocker)AnginaSecondary prevention after ACSArrhythmias including atrial fibrillationHeart failureThyrotoxicosisAnxietyProphylaxis of migraineEssential tremorGlaucoma

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      5.2
      Seconds
  • Question 28 - After collapsing in his nursing home, a 70-year-old man is brought into the...

    Correct

    • After collapsing in his nursing home, a 70-year-old man is brought into the ER. He is a known case of diabetes mellitus and is on medication for it. An RBS of 2.5 mmol/L (3.9-5.5 mmol/L) is recorded in the ER.

      Out of the following, which medication for diabetes mellitus is MOST likely responsible for his hypoglycaemic episode?

      Your Answer: Pioglitazone

      Explanation:

      Pioglitazone is used to treat type 2 diabetes mellitus. It selectively stimulates the nuclear receptor peroxisome proliferator-activated receptor gamma (PPAR-γ) and to a lesser extent PPAR-α.

      Of the medications mentioned in this question, only pioglitazone is a recognized cause of hypoglycaemia.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      17.1
      Seconds
  • Question 29 - A 57-year-old male presents to the orthopaedic clinic complaining of pain and swelling...

    Incorrect

    • A 57-year-old male presents to the orthopaedic clinic complaining of pain and swelling in the left knee joint. On examination, the left knee is swollen, tender and erythematous. The patient is booked for joint aspiration, and a diagnosis of pseudogout is made following the aspiration.

      Which types of crystals would be seen in the joint aspirate to lead to this diagnosis?

      Your Answer: Negatively birefringent needle-shaped crystals

      Correct Answer: Positively birefringent brick-shaped crystals

      Explanation:

      Gout and pseudogout are both characterised by crystal deposition in the affected joints. The deposition of urate crystals causes gout, while calcium pyrophosphate crystals cause pseudogout. The crystals can be distinguished microscopically because urate crystals are negatively birefringent needle-shaped crystals, whilst calcium pyrophosphate crystals are positively birefringent brick-shaped crystals.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      90
      Seconds
  • Question 30 - Regarding platelets, which of the following statements is CORRECT: ...

    Correct

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

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

      Explanation:

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

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
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