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  • Question 1 - A well recognised adverse effect of metoclopramide is which of the following? ...

    Incorrect

    • A well recognised adverse effect of metoclopramide is which of the following?

      Your Answer: Tinnitus

      Correct Answer: Acute dystonic reaction

      Explanation:

      Side effects of metoclopramide are commonly associated with extrapyramidal effects and hyperprolactinemia. Therefore its use must be limited to short-term use. Metoclopramide can induce acute dystonic reactions which involve facial and skeletal muscle spasms and oculogyric crises. These dystonic effects are more common in the young girls and young women, and in the very old. These symptoms usually occur shortly after starting treatment with this drug and subside within 24 hours of stopping it. Abortion of dystonic attacks can be carried out by injection of an antiparkinsonian drug like procyclidine.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      232.9
      Seconds
  • Question 2 - A 45-year-old man, a known case of epilepsy, visits his neurologist with complaints...

    Correct

    • A 45-year-old man, a known case of epilepsy, visits his neurologist with complaints of red, swollen gums.

      Which of the following medications is most likely responsible for his symptoms?

      Your Answer: Phenytoin

      Explanation:

      Phenytoin is a commonly used antiepileptic drug. A well-recognized side-effect of phenytoin is gingival enlargement and occurs in about 50% of patients receiving phenytoin. It is believed that reduced folate levels may cause this, and evidence suggests that folic acid supplementation may help prevent this in patients starting phenytoin.

      As evidence suggests, drug-induced gingival enlargement may also improve by substituting with other anticonvulsant drugs and reinforcing a good oral hygiene regimen. Surgical excision of hyperplastic gingiva is often necessary to correct the aesthetic and functional impairment associated with this condition to manage it successfully.

      Phenytoin is also the only anticonvulsant therapy associated with the development of Dupuytren’s contracture.
      Other side effects are:
      1. Ataxia
      2. Drug-induced lupus
      3. Hirsutism
      4. Pruritic rash
      5. Megaloblastic anaemia
      6. Nystagmus

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      44.2
      Seconds
  • Question 3 - In adult advanced life support, which of the following best describes the correct...

    Incorrect

    • In adult advanced life support, which of the following best describes the correct administration of adrenaline for a non-shockable rhythm:

      Your Answer: Give 0.5 mg of adrenaline as soon as intravenous access is achieved and every 3 - 5 minutes thereafter

      Correct Answer: Give 1 mg of adrenaline as soon as intravenous access is achieved and every 3 - 5 minutes thereafter

      Explanation:

      IV adrenaline 1 mg (10 mL of 1:10,000 solution) should be given after 3 shocks and every 3 – 5 minutes/after alternate shocks thereafter.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      6.4
      Seconds
  • Question 4 - A patient with abdominal pain, vomiting and bloody diarrhoea develops a low platelet...

    Correct

    • 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: 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
      15.8
      Seconds
  • Question 5 - Contraction of the diaphragm results in which of the following effects: ...

    Incorrect

    • Contraction of the diaphragm results in which of the following effects:

      Your Answer: Increased intrathoracic pressure

      Correct Answer: Increased vertical dimension of the thorax

      Explanation:

      Contraction of the diaphragm (as in inspiration) results in flattening (depression) of the diaphragm with an increase in vertical dimension of the thorax. This results in decreased intrathoracic pressure and increased intra-abdominal pressure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      22.3
      Seconds
  • Question 6 - Regarding antacids, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Antacids are contraindicated in hypocalcaemia.

      Correct Answer: Antacids should not be taken at the same time as other drugs as they impair absorption.

      Explanation:

      Antacids should preferably not be taken at the same time as other drugs since they may impair absorption. Antacids act by neutralising stomach acid. They are used for symptomatic relief in dyspepsia, but are not first line for proven peptic ulcer disease where antisecretory drugs have a better healing effect. Magnesium-containing antacids tend to be laxative whereas aluminium-containing antacids tend to be constipating. Antacids are contraindicated in hypophosphataemia.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      7.6
      Seconds
  • Question 7 - Regarding the varicella zoster virus, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the varicella zoster virus, which of the following statements is CORRECT:

      Your Answer: Chickenpox is usually more severe in children than in adults.

      Correct Answer: Contracting chickenpox infection while pregnant is associated with a higher risk of developing varicella pneumonitis.

      Explanation:

      Chickenpox infection in neonates, adults/adolescents and pregnant women is associated with more severe disease. Varicella zoster pneumonitis typically occurs in pregnant women or immunocompromised individuals and is associated with a high mortality. A live attenuated-virus vaccine is available and recommended for non-immune healthcare workers but is not part of the routine childhood immunisation schedule. Antiviral treatment is not typically recommended in childhood chickenpox but is indicated for shingles.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      2.3
      Seconds
  • Question 8 - Which of the following ligaments supports the head of the talus? ...

    Incorrect

    • Which of the following ligaments supports the head of the talus?

      Your Answer: Short plantar ligament

      Correct Answer: Spring ligament

      Explanation:

      The spring-ligament complex is a significant medial arch stabilizer.

      The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      15.5
      Seconds
  • Question 9 - Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for: ...

    Incorrect

    • Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for:

      Your Answer: Hyponatraemia

      Correct Answer: Hypocalcaemia

      Explanation:

      Common side effects of thiazide diuretics include:
      Excessive diuresis, postural hypotension, dehydration, renal impairment
      Acid-base and electrolyte imbalance
      Hypokalaemia, hyponatraemia, hypomagnesaemia, hypercalcaemia, hypochloraemic alkalosis
      Metabolic imbalance
      Hyperuricaemia and gout
      Impaired glucose tolerance and hyperglycaemia
      Altered plasma-lipid concentrations
      Mild gastrointestinal disturbances

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      41.3
      Seconds
  • Question 10 - Which of the following is the correct sequential order of the phases of...

    Incorrect

    • Which of the following is the correct sequential order of the phases of healing:

      Your Answer: Inflammation, haemostasis, proliferation, maturation

      Correct Answer: Haemostasis, inflammation, proliferation, remodelling

      Explanation:

      Acute wound healing has four main stages: haemostasis, inflammation, proliferation and remodelling.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      46.2
      Seconds
  • Question 11 - Which of the following is NOT a typical effect of cortisol: ...

    Incorrect

    • Which of the following is NOT a typical effect of cortisol:

      Your Answer: Increased glycolysis

      Correct Answer: Decreased protein catabolism

      Explanation:

      Cortisol is a steroid hormone produced in the zona fasciculata of the adrenal cortex. It is released in response to stress and low blood glucose concentrations.
      Cortisol acts to: raise plasma glucose by stimulating glycolysis and gluconeogenesis in the liver and inhibiting peripheral glucose uptake into storage tissues, increase protein breakdown in skeletal muscle, skin and bone to release amino acids, increase lipolysis from adipose tissues to release fatty acidsand at higher levels and mimic the actions of aldosterone on the kidney to retain Na+ and water and lose K+ ionssuppress the action of immune cells

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      58.6
      Seconds
  • Question 12 - An 85-year-old woman is brought in from her nursing home. She arrives in...

    Incorrect

    • An 85-year-old woman is brought in from her nursing home. She arrives in the Emergency Department and appears confused. The staff member from the nursing home accompanying her informs you that she takes a water tablet.

      From her past medical history and records, you deduce that the water tablet is a loop diuretic.

      Which of the following parts of a nephron does a loop diuretic act on?

      Your Answer: Glomerulus

      Correct Answer: Ascending loop of Henlé

      Explanation:

      Loop diuretics are drugs used to manage and treat fluid overload associated with CHF, liver cirrhosis, and renal disease. The drugs commonly used are:
      Furosemide
      Bumetanide
      Torsemide
      Ethacrynic Acid

      Loop diuretics act on the apical membrane of the thick ascending loop of Henle and inhibit the Na-K-Cl cotransporter. This blocks the reabsorption of sodium and chloride and results in salt-water excretion. This relieves congestion and reduces oedema.

      Other diuretics act on the following part of the nephron:
      1. Thiazide diuretics – Na/Cl co-transporter in the distal convoluted tubule
      2. Osmotic diuretics – PCT and the loop of Henle
      3. Aldosterone antagonists – distal convoluted tubule
      4. Carbonic anhydrase inhibitors – inhibit the carbonic anhydrase and act on proximal tubular cells

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      6
      Seconds
  • Question 13 - A 18 year old university student develops facial swelling and dark frothy urine. Urine...

    Incorrect

    • A 18 year old university student develops facial swelling and dark frothy urine. Urine dipstick demonstrates haematuria and proteinuria. Approximately 3 weeks ago, he was treated with oral antibiotics for a sore throat. His condition is most likely to be secondary to infection with:

      Your Answer: Staphylococcus epidermidis

      Correct Answer: Streptococcus pyogenes

      Explanation:

      Post-streptococcal glomerulonephritis is a postinfectious immune-mediated reaction secondary to infection with Streptococcus pyogenes. It typically occurs 2 weeks or more after acute/initial infection, and presents with haematuria, reduced urine output, peripheral oedema, proteinuria, and hypertension. Permanent kidney damage is rare.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      31
      Seconds
  • Question 14 - Regarding the phases of gastric secretion, which of the following statements is INCORRECT:...

    Incorrect

    • Regarding the phases of gastric secretion, which of the following statements is INCORRECT:

      Your Answer: Most acid secretion occurs in the gastric phase.

      Correct Answer: A high pH in the stomach inhibits gastrin secretion.

      Explanation:

      A low pH in the stomach inhibits gastrin secretion, therefore when the stomach is empty or when acid has been secreted for some time after food has entered it, there is inhibition of acid secretion. However, when food first enters the stomach, the pH rises, and this leads to release of the inhibition and causes a maximum secretion of gastrin. Thus gastric acid secretion is self-regulating.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      7.1
      Seconds
  • Question 15 - Which of the following tracts must be affected if a patient presents with...

    Incorrect

    • Which of the following tracts must be affected if a patient presents with decreased pain and temperature sensation in both lower extremities?

      Your Answer: The corticospinal tracts

      Correct Answer: The lateral spinothalamic tract

      Explanation:

      The main function of the spinothalamic tract is to carry pain and temperature via the lateral part of the pathway and crude touch via the anterior part. The spinothalamic tract pathway is an imperative sensory pathway in human survival because it enables one to move away from noxious stimuli by carrying pain and temperature information from the skin to the thalamus where it is processed and transmitted to the primary sensory cortex. The primary sensory cortex communicates with the primary motor cortex, which lies close to it, to generate rapid movement in response to potentially harmful stimuli. Furthermore, the spinothalamic tract has a role in responding to pruritogens, causing us to itch. Interestingly, itching suppresses the spinothalamic tract neuron response to the histamine effect.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      9.3
      Seconds
  • Question 16 - You intend to suture a hand wound with plain 1 percent lidocaine.

    In 1...

    Correct

    • You intend to suture a hand wound with plain 1 percent lidocaine.

      In 1 mL of plain 1 percent lidocaine solution, how much lidocaine hydrochloride is there?

      Your Answer: 10 mg lidocaine hydrochloride

      Explanation:

      10 mg of lidocaine hydrochloride is contained in each 1 mL of plain 1 percent lidocaine solution.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      35.3
      Seconds
  • Question 17 - Regarding gastric motility and emptying, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding gastric motility and emptying, which of the following statements is CORRECT:

      Your Answer: Cholecystokinin enhances gastric motility and gastric emptying.

      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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      2.7
      Seconds
  • Question 18 - About what percentage of filtered Na+is reabsorbed in the proximal tubule: ...

    Incorrect

    • About what percentage of filtered Na+is reabsorbed in the proximal tubule:

      Your Answer: 75 - 80%

      Correct Answer: 65 - 70%

      Explanation:

      Of the filtered sodium, about 65% is reabsorbed in the proximal tubule.

    • This question is part of the following fields:

      • Physiology
      • Renal
      31.5
      Seconds
  • Question 19 - A 20-year-old boy took almost 25 tablets of paracetamol almost 4 hours ago....

    Incorrect

    • A 20-year-old boy took almost 25 tablets of paracetamol almost 4 hours ago. The boy is healthy and has no known comorbid or drug history.

      Out of the following metabolic pathways, which one is primarily responsible for the toxic effects of paracetamol?

      Your Answer: Co-oxidation by peroxidases

      Correct Answer: N-hydroxylation

      Explanation:

      Paracetamol is predominantly metabolized in the liver by three main metabolic pathways:
      1. Glucuronidation (45-55%)
      2. Sulphate conjugation (30-35%)
      3. N-hydroxylation via the hepatic cytochrome P450 enzyme system (10-15%)

      Cytochrome P450 enzymes catalyse the oxidation of acetaminophen to the reactive metabolite N-acetyl-p-benzoquinoneimine (NAPQI). NAPQI primarily contributes to the toxic effects of acetaminophen. NAPQI is an intermediate metabolite that is further metabolized by fast conjugation with glutathione. The conjugated metabolite is then excreted in the urine as mercapturic acid. High doses of acetaminophen (overdoses) can lead to hepatic necrosis due to depleting glutathione and high binding levels of reactive metabolite (NAPQI) to important parts of liver cells.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      72.1
      Seconds
  • Question 20 - Fatigue, dizziness upon standing, muscle weakness, weight loss, nausea, and sweating are all symptoms...

    Incorrect

    • Fatigue, dizziness upon standing, muscle weakness, weight loss, nausea, and sweating are all symptoms that a patient may experience in Addison's disease.

      Which of the following claims about Addison's disease is correct?

      Your Answer: Hypokalaemia is a common feature

      Correct Answer: ACTH levels are elevated in primary insufficiency

      Explanation:

      The adrenal glands produce too little steroid hormones, which causes Addison’s disease. The production of glucocorticoids, mineralocorticoids, and sex steroids are all altered. The most prevalent cause is autoimmune adrenalitis, which accounts for 70-80 percent of cases.

      It affects more women than males and occurs most frequently between the ages of 30 and 50.

      The following are some of the clinical signs and symptoms of Addison’s disease:

      Weakness and sluggishness
      Hypotension is a condition in which the blood pressure (notably orthostatic hypotension)
      Vomiting and nausea
      Loss of weight
      Axillary and pubic hair loss
      Depression
      Hyperpigmentation is a condition in which a person’s (palmar creases, buccal mucosa and exposed areas more commonly affected)
      The following are the classic biochemical hallmarks of Addison’s disease:
      Hyponatraemia
      Hyperkalaemia
      Hypercalcaemia
      Hypoglycaemia
      Acidosis metabolica
      When ACTH levels are combined with cortisol levels, it is possible to distinguish between primary and secondary adrenal insufficiency:
      In primary insufficiency, levels rise.
      In secondary insufficiency, levels are low or low normal.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      3.8
      Seconds
  • Question 21 - Which of the following clinical features is a feature of a chronic extravascular...

    Incorrect

    • Which of the following clinical features is a feature of a chronic extravascular haemolytic anaemia:

      Your Answer: Raised serum conjugated bilirubin

      Correct Answer: Gallstones

      Explanation:

      Clinical features of haemolytic anaemia include:
      Anaemia
      Jaundice (caused by unconjugated bilirubin in plasma, bilirubin is absent from urine)
      Pigment gallstones
      Splenomegaly
      Ankle ulcers
      Expansion of marrow with, in children, bone expansion e.g. frontal bossing in beta-thalassaemia major
      Aplastic crisis caused by parvovirus

    • This question is part of the following fields:

      • Haematology
      • Pathology
      5.7
      Seconds
  • Question 22 - How is measles primarily transmitted: ...

    Correct

    • How is measles primarily transmitted:

      Your Answer: Respiratory droplet route

      Explanation:

      Measles belongs to the paramyxoviridae group of viruses. The incubation period is 7-18 days (average 10) and it is spread by airborne or droplet transmission. The classical presentation is of a high fever with coryzal symptoms and photophobia with conjunctivitis often being present. The rash that is associated is a widespread erythematous maculopapular rash. Koplik spots are pathognomonic for measles, and are the presence of white lesions on the buccal mucosa.
      Differential diagnoses would include:
      Rubella
      Roseola infantum (exanthem subitom)
      Scarlet fever
      Kawasaki disease
      Erythema infectiosum (5thdisease)
      Enterovirus
      Infectious mononucleosis
      Diagnosis can be confirmed by the following means:
      Salivary swab for measles specific IgM
      Serum sample for measles specific IgM
      Salivary swab for RNA detection
      Possible complications include:
      Otitis media
      Febrile convulsions
      Pneumonia
      Bronchiectasis
      Diarrhoea
      Meningitis
      Encephalitis
      Immunosuppression
      Subacute sclerosing panencephalitis
      Death

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      14.8
      Seconds
  • Question 23 - Glucagon may be used as an antidote for overdose with which of the...

    Incorrect

    • Glucagon may be used as an antidote for overdose with which of the following:

      Your Answer: Calcium channel blockers

      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 production

      Glycolysis 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.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      59.2
      Seconds
  • Question 24 - A 59-year-old man presents to the emergency room with chest pain. The cardiology...

    Incorrect

    • A 59-year-old man presents to the emergency room with chest pain. The cardiology team recently discharged him. He underwent a procedure and was given several medications, including abciximab, during his stay. Which of the following statements about abciximab is correct?

      Your Answer: It is contra-indicated in chronic renal insufficiency

      Correct Answer: It is a glycoprotein IIa/IIIb receptor antagonist

      Explanation:

      Abciximab (ReoPro) is a glycoprotein IIb/IIIa receptor antagonist that is a chimeric monoclonal antibody. It is primarily used during and after coronary artery procedures such as angioplasty to inhibit platelet aggregation.

      It’s approved for use as a supplement to heparin and aspirin in high-risk patients undergoing percutaneous transluminal coronary intervention to prevent ischaemic complications. Only one dose of abciximab should be given (to avoid additional risk of thrombocytopenia).

      Before using, it is recommended that baseline prothrombin time, activated clotting time, activated partial thromboplastin time, platelet count, haemoglobin, and haematocrit be measured. 12 and 24 hours after starting treatment, haemoglobin and haematocrit should be measured again, as should platelet count 2-4 hours and 24 hours after starting treatment.
      When used for high-risk patients undergoing angioplasty, the EPIC trial(link is external)found that abciximab reduced the risk of death, myocardial infarction, repeat angioplasty, bypass surgery, and balloon pump insertion.

      The use of abciximab is contraindicated in the following situations:
      Internal bleeding is present.
      Within the last two months, you’ve had major surgery, intracranial surgery, or trauma.
      Stroke in the previous two years
      Intracranial tumour
      Aneurysm or arteriovenous malformation
      Haemorrhagic diathesis is a type of haemorrhagic diathesis.
      Vasculitis
      Retinopathy caused by hypertension

      The following are some of the most common abciximab side effects:
      Manifestations of bleeding
      Bradycardia
      Back ache
      Pain in the chest
      Vomiting and nausea
      Pain at the puncture site
      Thrombocytopenia

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      10.1
      Seconds
  • Question 25 - A 55-year-old female is urgently rushed into the Emergency Department as she complains...

    Correct

    • A 55-year-old female is urgently rushed into the Emergency Department as she complains of chest pain that is worse on breathing, shortness of breath, palpitations, and haemoptysis.

      She undergoes a CT pulmonary angiogram, which reveals a large pulmonary embolus. She is immediately started on heparin and shifted to the acute medical ward.

      Which of the following does heparin activate?

      Your Answer: Antithrombin III

      Explanation:

      Heparin works by binding to and activating the enzyme inhibitor antithrombin III.

      Antithrombin III inactivates thrombin (factor IIa) by forming a 1:1 complex with thrombin. The heparin-antithrombin III complex also inhibits factor Xa and some other proteases involved with clotting. The heparin-ATIII complex can also inactivate IX, XI, XII, and plasmin.

      Heparin is a polymer of glycosaminoglycan. It occurs naturally and is found in mast cells. Clinically, it is used in two forms:
      1. Unfractionated: widely varying polymer chain lengths
      2. Low molecular weight: Smaller polymers only

      Heparin is not thrombolytic or fibrinolytic. It prevents the progression of existing clots by inhibiting further clotting. The lysis of existing clots relies on endogenous thrombolytics.

      Heparin is used for:
      1. Prevention and treatment of venous thromboembolism
      2. Treatment of disseminated intravascular coagulation
      3. Treatment of fat embolism
      4. Priming of haemodialysis and cardiopulmonary bypass machines

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      4.5
      Seconds
  • Question 26 - The lymph drainage of the anal canal above the pectinate line is initially...

    Incorrect

    • The lymph drainage of the anal canal above the pectinate line is initially to the:

      Your Answer: External iliac nodes

      Correct Answer: Internal iliac nodes

      Explanation:

      Above the pectinate line, the anal canal drains to the internal iliac lymph nodes which subsequently drain to the lumbar (para-aortic) nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      8.1
      Seconds
  • Question 27 - You have been asked to give a tutorial on common upper limb neurology...

    Correct

    • You have been asked to give a tutorial on common upper limb neurology to a group of medical students. You use the example of a man falling from a balcony onto spiked fencing, sustaining a puncture wound to the axilla. This results in an injury to the musculocutaneous nerve. Which of the following clinical features would you LEAST expect to see in this patient:

      Your Answer: Weakness of forearm pronation

      Explanation:

      Flexion of the arm and flexion and supination of the forearm are weakened but not lost entirely due to the actions of the pectoralis major and deltoid, the brachioradialis and the supinator muscles respectively. There is loss of sensation over the lateral aspect of the forearm. Forearm pronation would not be affected as this is primarily produced by the pronator quadratus and pronator teres muscles, innervated by the median nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      1.5
      Seconds
  • Question 28 - The patients listed below have been diagnosed with a variety of ailments.

    In which...

    Incorrect

    • The patients listed below have been diagnosed with a variety of ailments.

      In which of the following situations would aspirin be an effective treatment option?

      Your Answer: A 68-year-old with rheumatoid arthritis pain

      Correct Answer: A 36-year-old with an acute migraine (dose of 900-1000 mg)

      Explanation:

      A study published in the Cochrane Database of Systematic Reviews in 2010 found that a single 1000-mg dose of aspirin is effective in treating acute migraine. It was discovered that 24 percent of aspirin users were pain-free after two hours, compared to 11 percent of placebo users. Because the BNF recommends a maximum dose of 900 mg for analgesia and most non-proprietary aspirin comes in a dose of 300 mg, a dose of 900 mg is frequently prescribed in the UK.

      Because aspirin is not recommended for children under the age of 16 due to the risk of Reye’s syndrome, it would be inappropriate to give it to the 12-year-old with the viral URTI.

      For uncomplicated dental pain, aspirin is an acceptable option, but not for patients who are taking warfarin. The combination of aspirin’s antiplatelet action and warfarin’s anticoagulation properties puts the patient at high risk of bleeding. Furthermore, aspirin can deplete the therapeutic levels of warfarin by displacing it from plasma proteins. It would be better to use another NSAID or analgesic.

      In gout, aspirin should be avoided because it reduces urate clearance in the urine and interferes with the action of uricosuric agents. Naproxen, diclofenac, and indomethacin are better options.

      Although aspirin is useful for inflammatory pains, the dose of aspirin required for an adequate analgesic effect in severe pain is associated with significant side effects. Naproxen would be a better first-line treatment option.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      5.8
      Seconds
  • Question 29 - Regarding carbohydrate, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding carbohydrate, which of the following statements is INCORRECT:

      Your Answer: Carbohydrates are the main energy source of most diets.

      Correct Answer: Most dietary carbohydrate is in the form of disaccharides.

      Explanation:

      Carbohydrates are the main energy source of most diets. They provide 17 kJ (4 kcal) of energy per gram. Most dietary carbohydrate is in the form of polysaccharides. The principal ingested polysaccharides are starch which is derived from plant sources and glycogen which is derived from animal sources. Dietary fibre consists of indigestible carbohydrate (found in plant foods) such as cellulose, lignin and pectin.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      2.6
      Seconds
  • Question 30 - A patient presents to your Emergency Department with a laceration on their buttocks...

    Incorrect

    • A patient presents to your Emergency Department with a laceration on their buttocks requiring closure with sutures.

      What stage of wound healing is the first to reach completion?

      Your Answer:

      Correct Answer: Haemostasis

      Explanation:

      The stages of wound healing are: haemostasis, inflammatory, proliferative and remodelling (maturation) phases in that order. The first stage in the healing process of a laceration is haemostasis. Haemostasis is the process of the wound being closed by clotting.

      The inflammatory phase occurs just after and up to 48 hours after injury– Blood vessels dilate to allow white blood cells, antibodies, growth factors, enzymes and nutrients to reach the wounded area leading to the characteristic signs of inflammation seen.

      Epithelialisation and angiogenesis are not phases of wound healing but occur during the proliferative phase. This ia after haemolysis and inflammation phases have occurred.

      The maturation phase is the final phase and occurs when the wound has closed. It involves remodelling of collagen from type III to type I. Apoptosis remove unwanted cells, cellular activity reduces and the number of blood vessels in the wounded area regresses and decreases. This can continues for up to 1 year after injury.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
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