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  • Question 1 - Which of the following medications may lessen warfarin's anticoagulant effect: ...

    Correct

    • Which of the following medications may lessen warfarin's anticoagulant effect:

      Your Answer: Phenytoin

      Explanation:

      Phenytoin will decrease the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.Metronidazole will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism.NSAIDs, when given with Warfarin, increase anticoagulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      21.9
      Seconds
  • Question 2 - Which nerve supplies the muscle flexor hallucis longus? ...

    Incorrect

    • Which nerve supplies the muscle flexor hallucis longus?

      Your Answer: Deep peroneal nerve

      Correct Answer: Tibial nerve

      Explanation:

      Flexor hallucis longus is innervated by the tibial nerve, composed of spinal roots L4, L5, S1, S2, and S3.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.6
      Seconds
  • Question 3 - A 34-year-old man arrives at the department befuddled. He has a history of...

    Incorrect

    • A 34-year-old man arrives at the department befuddled. He has a history of schizophrenia and is on an antipsychotic medication, but he can't recall what it's called.Which of the following statements about antipsychotic drug side effects is correct?

      Your Answer: Dystonia is most common in middle-aged adults

      Correct Answer: Haloperidol is the most common causative antipsychotic drug

      Explanation:

      Extrapyramidal side effects are most common with piperazine phenothiazines (fluphenazine, prochlorperazine, and trifluoperazine) and butyrophenones (fluphenazine, prochlorperazine, and trifluoperazine) (benperidol and haloperidol). The most common causative antipsychotic drug is haloperidol.Tardive dyskinesia (rhythmic, involuntary movements of the tongue, face, and jaw) is most commonly associated with long-term or high-dose treatment. It is the most serious form of extrapyramidal symptoms because withdrawal of the causative drug may make it irreversible, and treatment is usually ineffective.Dystonia (abnormal facial and body movements) is more common in children and young adults, and it usually shows up after only a few doses. Procyclidine 5 mg IV or benzatropine 2 mg IV as a bolus can be used to treat acute dystonia.An unpleasant feeling of restlessness characterises akathisia. The inability to initiate movement is known as akinesia.Renal impairment causes increased cerebral sensitivity, so lower doses should be used.In elderly patients with dementia-related psychosis who are treated with haloperidol, there is an increased risk of death. This appears to be due to a higher risk of heart attacks and infections like pneumonia.The following are some of the antipsychotic drugs’ contraindications:Reduced level of consciousness/comaDepression of the central nervous systemPhaeochromocytoma

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      69.9
      Seconds
  • Question 4 - Which of the following does not increase renal phosphate excretion? ...

    Correct

    • Which of the following does not increase renal phosphate excretion?

      Your Answer: Vitamin D

      Explanation:

      PO43-renal excretion is regulated several mechanisms. These include:-parathyroid hormone – increases excretion by inhibiting reabsorption in the proximal tubule-acidosis – increases excretion-glucocorticoids – increases excretion-calcitonin – increases excretion-activated vitamin D – decreases excretion by increasing reabsorption in the distal tubule

    • This question is part of the following fields:

      • Physiology
      • Renal
      23.4
      Seconds
  • Question 5 - Which of the following describes the pulse pressure: ...

    Correct

    • Which of the following describes the pulse pressure:

      Your Answer: Systolic - diastolic pressure

      Explanation:

      During systole, the pressure in the left ventricle increases and blood is ejected into the aorta. The rise in pressure stretches the elastic walls of the aorta and large arteries and drives blood flow. Systolic pressure is the maximum arterial pressure during systole. During diastole, arterial blood flow is partly maintained by elastic recoil of the walls of large arteries. The minimum pressure reached before the next systole is the diastolic pressure. The difference between the systolic and diastolic pressure is the pulse pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      6.6
      Seconds
  • Question 6 - A patient was diagnosed with Erb's palsy as a result of a brachial...

    Correct

    • A patient was diagnosed with Erb's palsy as a result of a brachial plexus injury sustained in a car accident and, as a result, suffers from left arm paralysis. The following muscles are affected by the injury, except

      Your Answer: Trapezius

      Explanation:

      Damage to the C5 and C6 nerve roots causes Erb’s palsy. The spinal accessory nerve (CN XI) innervates the trapezius muscle, thus you would not expect this muscle to be impacted. The trapezius is a muscle that runs from the base of the neck across the shoulders and into the centre of the back.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      16.6
      Seconds
  • Question 7 - In ventricular myocytes, the plateau phase of the action potential comes about through which...

    Incorrect

    • In ventricular myocytes, the plateau phase of the action potential comes about through which of the following:

      Your Answer: Opening of voltage-gated K + channels

      Correct Answer: Opening of voltage-gated Ca 2+ channels

      Explanation:

      After the intial upstroke of the action potential, Na+channels and currents rapidly inactivate, but in cardiac myocytes, the initial depolarisation activates voltage-gated Ca2+channels (slow L-type channels, threshold approximately – 45 mV) through which Ca2+floods into the cell. The resulting influx of Ca2+prevents the cell from repolarising and causes a plateau phase, that is maintained for about 250 ms until the L-type channels inactivate. The cardiac AP is thus much longer than that in nerve or skeletal muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      29.4
      Seconds
  • Question 8 - Which of the following clinical features is most suggestive of a lesion of...

    Incorrect

    • Which of the following clinical features is most suggestive of a lesion of the temporal lobe:

      Your Answer: Hemispatial neglect

      Correct Answer: Receptive dysphasia

      Explanation:

      Damage to the Wernicke’s speech area in the temporal lobe can result in a receptive dysphasia. Hemispatial neglect is most likely to occur in a lesion of the parietal lobe. Homonymous hemianopia is most likely to occur in a lesion of the occipital lobe. Expressive dysphasia is most likely to occur in a lesion of the Broca speech area in the frontal lobe. Conjugate eye deviation towards the side of the lesion is most likely to occur in a lesion of the frontal lobe.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      28.1
      Seconds
  • Question 9 - The ventilation over perfusion ratio is highest at the apex of the lung....

    Incorrect

    • The ventilation over perfusion ratio is highest at the apex of the lung. What is the approximate V/Q ratio at this area?

      Your Answer:

      Correct Answer: 3.3

      Explanation:

      The ventilation/perfusion ratio (V/Q ratio) is a ratio used to assess the efficiency and adequacy of the matching ventilation and perfusion. The ideal V/Q ratio is 1.Any mismatch between ventilation and perfusion will be evident in the V/Q ratio. If perfusion is normal but ventilation is reduced, the V/Q ratio will be less than 1, whereas if ventilation is normal, but perfusion is reduced, the V/Q ratio will be greater than 1. If the alveoli were ventilated but not perfused at all, then the V/Q ratio would be infinity. The V/Q ratio is also affected by location. The various areas of the lungs have a different V/Q ratio since ventilation and perfusion increase from the apex to the base of the lungs. The apex of the lungs has a V/Q ratio of approximately 3.3.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      0
      Seconds
  • Question 10 - You proceed to administer lorazepam intravenously to a 21-year-old patient with status epilepticus....

    Incorrect

    • You proceed to administer lorazepam intravenously to a 21-year-old patient with status epilepticus. Which of the following best describes lorazepam's action?

      Your Answer:

      Correct Answer: Potentiates effect of GABA

      Explanation:

      Lorazepam is a type of benzodiazepine. Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists with sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant characteristics that promote inhibitory synaptic transmission across the central nervous system.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 11 - A 22-year-old man arrives at the emergency department with a sore throat, low-grade...

    Incorrect

    • A 22-year-old man arrives at the emergency department with a sore throat, low-grade fever, and malaise. His partner has infectious mononucleosis, which was recently diagnosed. In this situation, which of the following cells is the most proliferative:

      Your Answer:

      Correct Answer: Lymphocytes

      Explanation:

      Histologic findings in EBV infectious mononucleosis: Oropharyngeal epithelium demonstrates an intense lymphoproliferative response in the cells of the oropharynx. The lymph nodes and spleen show lymphocytic infiltration primarily in the periphery of a lymph node.Relative lymphocytosis (≥ 60%) plus atypical lymphocytosis (≥ 10%) are the characteristic findings of Epstein Barr virus (EBV) infectious mononucleosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds
  • Question 12 - A patient who was put on low molecular weight heparin for suspected DVT...

    Incorrect

    • A patient who was put on low molecular weight heparin for suspected DVT and was scheduled for an ultrasound after the weekend, arrives at the emergency department with significant hematemesis. Which of the following medications can be used as a heparin reversal agent:

      Your Answer:

      Correct Answer: Protamine sulfate

      Explanation:

      The management of bleeding in a patient receiving heparin depends upon the location and severity of bleeding, the underlying thromboembolic risk, and the current aPTT (for heparin) or anti-factor Xa activity (for LMW heparin). As an example, a patient with minor skin bleeding in the setting of a mechanical heart valve (high thromboembolic risk) and a therapeutic aPTT may continue heparin therapy, whereas a patient with major intracerebral bleeding in the setting of venous thromboembolism several months prior who is receiving heparin bridging perioperatively may require immediate heparin discontinuation and reversal with protamine sulphate. If haemorrhage occurs it is usually sufficient to withdraw unfractionated or low molecular weight heparin, but if rapid reversal of the effects of the heparin is required, protamine sulphate is a specific antidote (but only partially reverses the effects of low molecular weight heparins). Clinician judgment and early involvement of the appropriate consulting specialists is advised.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 13 - All of the following single clinical risk groups is considered eligible to receive...

    Incorrect

    • All of the following single clinical risk groups is considered eligible to receive the seasonal influenza vaccination, except:

      Your Answer:

      Correct Answer: Patients with hypertension

      Explanation:

      The following is the list of all the health and age factors that are known to increase a person’s risk of getting serious complications from flu:- Adults 65 years and older- Children younger than 2 years old- Asthma- Neurological and neurodevelopmental conditions- Blood disorders (such as sickle cell disease)- Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)- Endocrine disorders (such as diabetes mellitus)- Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)- Kidney diseases- Liver disorders- Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)- People who are obese with a body mass index [BMI] of 40 or higher- People younger than 19 years old on long-term aspirin- or salicylate-containing medications.- People with a weakened immune system due to disease (such as people with HIV or AIDS, or some cancers such as leukaemia) or medications (such as those receiving chemotherapy or radiation treatment for cancer, or persons with chronic conditions requiring chronic corticosteroids or other drugs that suppress the immune system)- People who have had a stroke- Pregnant people and people up to 2 weeks after the end of pregnancy- People who live in nursing homes and other long-term care facilities

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds
  • Question 14 - In a patient with an ongoing seizure, after what time period should treatment...

    Incorrect

    • In a patient with an ongoing seizure, after what time period should treatment be commenced?

      Your Answer:

      Correct Answer: 5 minutes

      Explanation:

      Immediate emergency care and treatment should be given to children, young people and adults who have prolonged or repeated convulsive seizures.Prolonged seizures last 5 minutes or more. Repeated seizures refer to 3 or more seizures in an hour.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 15 - Many of the chemical digestion and absorption takes place in the small intestine....

    Incorrect

    • Many of the chemical digestion and absorption takes place in the small intestine. Most digestive enzymes in the small intestine are secreted by the pancreas and enter the small intestine through the pancreatic duct.Which of these digestive enzymes is responsible for breaking down carbohydrates into monosaccharides?

      Your Answer:

      Correct Answer: Glucoamylase

      Explanation:

      Majority of carbohydrates are broken down into monosaccharides (glucose, fructose galactose) and are absorbed by the small intestine. Enzymes released from the brush border break down carbohydrate. Some carbohydrates, such as cellulose, are not digested at all, despite being made of multiple glucose units. This is because the cellulose is made out of beta-glucose that makes the inter-monosaccharide bindings different from the ones present in starch, which consists of alpha-glucose. Humans lack the enzyme for splitting the beta-glucose-bond.The principal brush border enzymes are dextranase and glucoamylase. Other brush border enzymes are maltase, sucrase, and lactase.Pancreatic amylase breaks down some carbohydrates (notably starch) into oligosaccharides. Dextranase and glucoamylase, then further break down oligosaccharides.Trypsin aids in digestion of protein.Chymotrypsin is a proteolytic enzyme that digests proteinCarboxypeptidase hydrolyses the first peptide or amide bond at the carboxyl or C-terminal end of proteins and peptides

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      0
      Seconds
  • Question 16 - Which of the following is the most common cause of hyperthyroidism: ...

    Incorrect

    • Which of the following is the most common cause of hyperthyroidism:

      Your Answer:

      Correct Answer: Graves disease

      Explanation:

      Graves disease is the most common cause of hyperthyroidism. It is an autoimmune disease in which autoantibodies against TSH receptors are produced. These antibodies bind to and stimulate these TSH receptors leading to an excess production of thyroid hormones. Therefore, the signs and symptoms of Graves disease are the same as those of hyperthyroidism, reflecting the actions of increased circulating levels of thyroid hormones: increased heat production, weight loss, increased 02 consumption and cardiac output and exophthalmos (bulging eyes, not drooping eyelids). TSH levels will be decreased (not increased) as a result of the negative feedback effect of increased T3 levels on the anterior pituitary.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 17 - A 60-year-old male presents to the genitourinary clinic with dysuria and urinary frequency...

    Incorrect

    • 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:

      Correct Answer: Nitrofurantoin

      Explanation:

      The NICE guidelines for men with lower UTIs are:1. Prescribe an antibiotic immediately, taking into account the previous urine culture and susceptibility results or avoiding antibiotics used previously that may have caused resistance 2. Obtain a midstream urine sample before starting antibiotics and send for urine culture and susceptibility – Review the choice of antibiotic when the results are available AND- change the antibiotic according to susceptibility results if the bacteria are resistant and symptoms are not improving, using a narrow-spectrum antibiotic wherever possibleThe first choice of antibiotics for men with lower UTIs is:1. Trimethoprim200 mg PO BD for seven days2. Nitrofurantoin100 mg modified-release PO BD for 3 days – if eGFR >45 ml/minuteIn men whose symptoms have not responded to a first-choice antibiotic, alternative diagnoses (such as acute pyelonephritis or acute prostatitis) should be considered. Second-choice antibiotics should be based on recent culture and susceptibility results.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds
  • Question 18 - Loop diuretics primarily act on which Na+ transporter? ...

    Incorrect

    • Loop diuretics primarily act on which Na+ transporter?

      Your Answer:

      Correct Answer: Na + /K + /2Cl - symporter

      Explanation:

      The most potent diuretics are loop diuretics e.g. furosemide. They work by inhibiting the Na+/K+/2Cl-symporter in the thick ascending limb of the loop of Henle, which inhibits sodium, potassium, and chloride reabsorption. As a result, there is diuresis with loss of these electrolytes. There is a reduction in transcellular voltage difference, paracellular calcium and magnesium reabsorption.The medullary interstitium becomes more concentrated by salt reabsorption in the ascending limb. Loop diuretics block this process and reduce the ability of the kidney to concentrate urine. In the collecting duct, there is increased sodium delivery to the principal cells, which increases potassium secretion in return for sodium reabsorption.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 19 - All of the following statements are considered true regarding randomized control trials, except:...

    Incorrect

    • All of the following statements are considered true regarding randomized control trials, except:

      Your Answer:

      Correct Answer: They can eliminate the need for further studies

      Explanation:

      Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess previous research studies to derive conclusions about that body of research. Outcomes from a meta-analysis may include a more precise estimate of the effect of treatment or risk factor for disease, or other outcomes, than any individual study contributing to the pooled analysis. The examination of variability or heterogeneity in study results is also a critical outcome.The benefits of meta-analysis include a consolidated and quantitative review of a large, and often complex, sometimes apparently conflicting, body of literature. The specification of the outcome and hypotheses that are tested is critical to the conduct of meta-analyses, as is a sensitive literature search.Important medical questions are typically studied more than once, often by different research teams in different locations. In many instances, the results of these multiple small studies of an issue are diverse and conflicting, which makes the clinical decision-making difficult. The need to arrive at decisions affecting clinical practise fostered the momentum toward evidence-based medicine. Evidence-based medicine may be defined as the systematic, quantitative, preferentially experimental approach to obtaining and using medical information. Therefore, meta-analysis, a statistical procedure that integrates the results of several independent studies, plays a central role in evidence-based medicine.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds
  • Question 20 - What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:...

    Incorrect

    • What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:

      Your Answer:

      Correct Answer: Beta1-receptor agonist

      Explanation:

      Dobutamine directly stimulates the beta1-adrenergic receptors in the heart and increases contractility and cardiac output with little effect on the rate. In addition action on beta2-receptors causes vasodilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 21 - A 50-year-old man presents with headaches, lethargy, hypertension, and electrolyte disturbance. A diagnosis...

    Incorrect

    • A 50-year-old man presents with headaches, lethargy, hypertension, and electrolyte disturbance. A diagnosis of primary hyperaldosteronism is made.Which biochemical pictures would best support this diagnosis?

      Your Answer:

      Correct Answer: Hypokalaemic metabolic alkalosis

      Explanation:

      When there are excessive levels of aldosterone outside of the renin-angiotensin axis, primary hyperaldosteronism occurs. High renin levels will lead to secondary hyperaldosteronism. The classical presentation of hyperaldosteronism when symptoms are present include:HypokalaemiaMetabolic alkalosisHypertensionNormal or slightly raised sodium levels

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds
  • Question 22 - Which of the following nerves provides cutaneous innervation to the posterior surface of...

    Incorrect

    • Which of the following nerves provides cutaneous innervation to the posterior surface of the scrotum?

      Your Answer:

      Correct Answer: Branch of the perineal nerve

      Explanation:

      The following nerves provide cutaneous innervation to the scrotum, and other anatomic structures:The perineal nerve supplies the muscles in the urogenital triangle, and the skin on the posterior surface of the scrotum (or labia majora).The genital branch of the genitofemoral nerve supplies the cremaster muscle, the skin over the anterior surface of the thigh, and the anterolateral surface of the scrotum.The ilioinguinal nerve supplies the external oblique, internal oblique, transversus abdominis, skin of the upper medial aspect of thigh, the root of the penis and the anterior surface of the scrotum in the male, and the mons pubis and labia majora in the female.The posterior cutaneous nerve of the thigh, or posterior femoral cutaneous nerve, supplies the skin over the lower medial quadrant of the buttock, the inferior skin of the scrotum or labium majus, and the back of the thigh and the upper part of the leg.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      0
      Seconds
  • Question 23 - CSF is reabsorbed from subarachnoid space via which of the following structures: ...

    Incorrect

    • CSF is reabsorbed from subarachnoid space via which of the following structures:

      Your Answer:

      Correct Answer: Arachnoid granulations

      Explanation:

      From the subarachnoid cisterns in the subarachnoid space, CSF is reabsorbed via arachnoid granulations which protrude into the dura mater, into the dural venous sinuses and from here back into the circulation.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 24 - What is the pathophysiology of a phaeochromocytoma: ...

    Incorrect

    • What is the pathophysiology of a phaeochromocytoma:

      Your Answer:

      Correct Answer: Catecholamine-secreting tumour

      Explanation:

      Phaeochromocytomas are catecholamine-secreting tumours which occur in about 0.1% of patients with hypertension. In about 90% of cases they arise from the adrenal medulla. The remaining 10%, which arise from extra-adrenal chromaffin tissue, are termed paragangliomas. Common presenting symptoms include one or more of headache, sweating, pallor and palpitations. Less commonly, patients describe anxiety, panic attacks and pyrexia. Hypertension, whether sustained or episodic, is present in at least 90% of patients. Left untreated phaeochromocytoma can occasionally lead to hypertensive crisis, encephalopathy, hyperglycaemia, pulmonary oedema, cardiac arrhythmias, or even death.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 25 - Which of the following nerves supplies innervation to the extensor hallucis longus? ...

    Incorrect

    • Which of the following nerves supplies innervation to the extensor hallucis longus?

      Your Answer:

      Correct Answer: Deep peroneal nerve

      Explanation:

      Extensor hallucis longus is innervated by the deep fibular nerve (root value L5 and S1).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 26 - 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:

      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
      0
      Seconds
  • Question 27 - A 60-year-old man with insulin-controlled diabetes mellitus asks you about how his ability...

    Incorrect

    • A 60-year-old man with insulin-controlled diabetes mellitus asks you about how his ability to drive is affected. He owns a car as well as a motorcycle.Which of the following statements about driving with diabetes under insulin control is correct?

      Your Answer:

      Correct Answer: He must monitor his blood glucose levels every 2 hours whilst driving

      Explanation:

      The DVLA sends a detailed information sheet about their licence and driving to all drivers with diabetes mellitus. The primary danger of driving while diabetic is hypoglycaemia.The DVLA must be notified of the following diabetic patients:All of the drivers are on insulin. (Licenses are being reviewed more frequently.)Those who are at high risk of hypoglycaemia and have had more than one episode of severe hypoglycaemia in the previous year. (Severe hypoglycaemia is defined as requiring the assistance of another person to manage.)Those who are unaware of their hypoglycaemiaAnyone who has ever been in a car accident due to hypoglycaemiaAnyone with diabetic retinopathy who needs laser treatment (to both eyes or to a second eye if sight only in one eye)Patients with diabetes complications that impair their ability to drive.To drive, drivers with insulin-treated diabetes must meet the following requirements:They need to be aware of hypoglycaemia.They must not have had more than one episode of hypoglycaemia in the previous 12 months that necessitated the assistance of another person.They must check their blood glucose levels no later than 2 hours before the first journey.While driving, they must check their blood glucose levels every two hours.The visual acuity and visual field standards must be met.Any significant changes in their condition must be reported to the DVLA. Furthermore, on days when they are not driving, group 2 licence holders must test their blood glucose twice daily using a metre that can store three months’ worth of readings.In addition to this advice, the DVLA also offers the following advice to diabetic patients:When taking tablets that have the potential to cause hypoglycaemia (such as sulfonylureas and glinides), monitoring may be necessary if there has been more than one episode of severe hypoglycaemia.Drivers must show good control and be able to recognise hypoglycaemia.Verify that your vision meets the required standard.If a patient feels hypoglycaemic or has a blood glucose level of less than 4.0 mmol/L, they should not drive. Driving should not be resumed until blood glucose levels have returned to normal, which should take 45 minutes.If there are any warning signs, patients should carry rapidly absorbed sugar in their vehicle and stop, turn off the ignition, and eat it.If resuscitation is required, a card stating which medications they are taking should be carried.If hypoglycaemia causes an accident, a diabetic driver may be charged with driving under the influence of drugs.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 28 - You review a 37-year-old man with a history of intravenous drug abuse who...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds
  • Question 29 - External haemorrhoids may cause anal pain. When explaining to your patient why it...

    Incorrect

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

      Your Answer:

      Correct Answer: Pudendal nerve

      Explanation:

      The pain associated with external haemorrhoids is carried by a branch of the pudendal nerve, specifically the somatic fibres (S2-S4). It innervates the external anal sphincter and most of the skin over the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 30 - Regarding the accessory nerve, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding the accessory nerve, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Accessory nerve palsy results in the inability to nod the head.

      Explanation:

      Accessory nerve palsy results in inability to shrug the shoulders and to rotate the head to look at the opposite side to the lesion.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (2/3) 67%
Pharmacology (1/2) 50%
Anatomy (1/3) 33%
Lower Limb (0/1) 0%
CNS Pharmacology (0/1) 0%
Physiology (2/3) 67%
Renal (1/1) 100%
Upper Limb (1/1) 100%
Central Nervous System (0/1) 0%
Passmed