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Question 1
Incorrect
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What is the correct adrenaline dose for a patient with pulseless ventricular tachycardia?
Your Answer: 0.5 ml of 1 in 1000 adrenaline solution
Correct Answer: 10 ml of 1 in 10,000 adrenaline solution
Explanation:Ventricular fibrillation or pulseless ventricular tachycardia (VF/VT) are referred to as shockable rhythm. IV adrenaline 1 mg (10 mL of 1:10,000 solution) should be administered after 3 shocks and every 3 – 5 minutes/after alternate shocks thereafter for a shockable rhythm. For a non-shockable rhythm, 1 mg IV adrenaline should be administered as soon as IV access is obtained, and then every 3 – 5 minutes/after alternate shocks thereafter.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 2
Correct
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Regarding ciprofloxacin, which of the following statements is INCORRECT:
Your Answer: Ciprofloxacin decreases plasma concentrations of theophylline.
Explanation:Ciprofloxacin increases plasma concentrations of theophylline. There is an increased risk of convulsions when quinolones are given with NSAIDs or theophylline. There is an increased risk of tendon damage when quinolones are given with corticosteroids. Quinolones are known to increase the QT-interval and should not be taken with concomitantly with other drugs that are known to cause QT-interval prolongation. There is an increased risk of myopathy when erythromycin or clarithromycin are taken with simvastatin or atorvastatin.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 3
Incorrect
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Before a patient is discharged, you are asked to review them. He is a 59-year-old man who was seen with epigastric pain that has since subsided, and he will be seen by his GP in the coming days. He's been hearing a lot about aspirin lately and wants to learn more about it.Which of the following statements about aspirin's mechanism of action is correct?
Your Answer: Inhibition of platelet ADP receptors
Correct Answer: Inhibition of cyclo-oxygenase
Explanation:Aspirin works by inhibiting cyclo-oxygenase in an irreversible manner, resulting in a decrease in prostaglandin and thromboxane production. As a result, platelet activation and aggregation are reduced.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 4
Incorrect
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A 40-year-old man with reduced urine output, nausea, and confusion also has a 150% rise of creatinine from baseline over the past 7 days. A diagnosis of acute kidney injury (AKI) is made after more tests are done.His AKI stage is?
Your Answer: Stage 3
Correct Answer: Stage 2
Explanation:This patient with a 150% rise of creatinine above baseline within 7 days has stage 2 Acute kidney injury (AKI).AKI stages are as follows:Stage 1Creatinine rise of 26 micromole/L or more within 48 hours, orCreatinine rise of 50-99% from baseline within 7 days (1.5-1.99 x baseline),orUrine output <0.5 mL/kg/hour for more than 6 hoursStage 2Creatinine rise of 100-199% from baseline within 7 days (2.0-2.99 x baseline),orUrine output <0.5 mL/kg/hour for more than 12 hoursStage 3Creatinine rise of 200% or more from baseline within 7 days (3.0 or more x baseline), orCreatinine rise to 354 micromole/L or more with acute rise of 26 micromole/L or more within 48 hours or 50% or more rise within 7 days, orUrine output <0.3 mL/kg/hour for 24 hours or anuria for 12 hours
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 5
Incorrect
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Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT for:
Your Answer:
Correct Answer: Hepatitis A
Explanation:Disease specific immunoglobulins are available for:hepatitis Brabiestetanusvaricella-zosterNormal immunoglobulin can be used to confer protection against hepatitis A.
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This question is part of the following fields:
- Immunoglobulins And Vaccines
- Pharmacology
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Question 6
Incorrect
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A 17-year-old male presenting in the department has a history of C3 deficiency.C3 deficiency is associated with all of the following EXCEPT?
Your Answer:
Correct Answer: Hereditary angioedema
Explanation:C1-inhibitor deficiency is the cause of hereditary angioedema not C3 deficiency,All the other statements are correct
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 7
Incorrect
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Which of the following is NOT a typical clinical feature of sickle cell disease:
Your Answer:
Correct Answer: Neutropaenia
Explanation:Features of sickle cell disease include:Anaemia (symptoms are usually mild because the O2 dissociation curve of Hb S is shifted to the right)Vaso-occlusive crisisVisceral sequestration crisisAplastic crisisIncreased susceptibility to infectionOther clinical features: Pigment gallstones with cholecystitisChronic leg ulcersAvascular necrosis of the femoral and humeral heads or other bonesCardiomyopathyPulmonary hypertensionProliferative retinopathyPriapismRenal papillary necrosisStroke
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This question is part of the following fields:
- Haematology
- Pathology
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Question 8
Incorrect
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Which one these is an example of a cause of an exudate?
Your Answer:
Correct Answer: Subphrenic abscess
Explanation:An exudate is an inflammatory fluid emanating from the intravascular space due to changes in the permeability of the surrounding microcirculation.Some common causes of exudates are: pneumonia, empyema, lung cancer, breast cancer, cancer of the pleura, SLE, rheumatoid arthritis, pericarditis, subphrenic abscess, chylothorax.Myxoedema, nephrotic syndrome, congestive cardiac failure, and liver cirrhosis all cause TRANSUDATE.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 9
Incorrect
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Which of the following does NOT typically cause a neutrophil leucocytosis:
Your Answer:
Correct Answer: Glandular fever
Explanation:Causes of neutrophil leucocytosis:Bacterial infectionInflammation and tissue necrosis (e.g. cardiac infarct, trauma, vasculitis, myositis)Metabolic disorders (e.g. uraemia, acidosis, eclampsia, gout)PregnancyAcute haemorrhage or haemolysisNeoplasms of all typesDrugs (e.g. corticosteroid therapy, lithium, tetracyclines)AspleniaMyeloproliferative disorders (e.g. CML, essential thrombocythaemia, polycythaemia vera, myelofibrosis)Rare inherited disorders
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 10
Incorrect
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Which ONE statement about homeostasis is true?
Your Answer:
Correct Answer: Negative feedback occurs via receptors, comparators and effectors
Explanation:Homeostasis is the property of a system in which variables are regulated so that internal conditions remain relatively constant and stable. Homeostasis is achieved by a negative feedback mechanism.Negative feedback occurs based upon a set point through receptors, comparators and effectors. The ‘set point’ is a NARROW range of values within which normal function occurs.The two body systems that regulate homeostasis are the Nervous system and the Endocrine system. The smooth muscle of the uterus becomes more active towards the end of pregnancy. This is a POSITIVE feedback.
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This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 11
Incorrect
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A 7-year-old presented to a GP with a history of headache, neck stiffness and photophobia. On examination, HR is 122, BP is 87/42, RR is 28, SaO 2 is 95%, temperature is 39.4 o C. There is a recent non-blanching rash on legs and arms. The GP administered a dose of antibiotics before transferring child to the Emergency Department.Which of these is the most appropriate antibiotic to administer in this scenario from the choices available?
Your Answer:
Correct Answer: Give IM benzylpenicillin 600 mg
Explanation:Meningococcal septicaemia should be suspected in a child with a non-blanching rash especially in the presence of:An ill-looking childNeck stiffnessLesions larger than 2 mm in diameter (purpura)Capillary refill time of>3 secondsThe index child is very sick and shows signs of septic shock. In the prehospital setting, a single dose of benzylpenicillin should be given immediately. The correct dose for this childs age is IM benzylpenicillin 600 mg.The recommended doses of benzylpenicillin according to age are:Infants <1 year of age: IM or IV benzylpenicillin 300 mgChildren 1 to 9 years of age: IM or IV benzylpenicillin 600mgChildren and adults 10 years or older: IM or IV benzylpenicillin 1.2g
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 12
Incorrect
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A suspicious growth on the posterior tongue of a 40-year-old man was discovered by his dentist and was immediately referred for possible oral cancer. The lymph from the posterior tongue will drain to which of the following nodes?
Your Answer:
Correct Answer: Deep cervical nodes
Explanation:Lymph from the medial anterior two thirds of the tongue travels to the deep cervical lymph nodes.Lymph from the lateral anterior tongue goes to the submandibular nodes.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 13
Incorrect
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You are teaching a group of medical students about cardiovascular examination. You are discussing heart sounds and the cardiac cycle. Which of the following stages of the cardiac cycle occurs immediately after the aortic valve closes:
Your Answer:
Correct Answer: Isovolumetric relaxation
Explanation:Immediately after the closure of the semilunar valves, the ventricles rapidly relax and ventricular pressure decreases rapidly but the AV valves remain closed as initially the ventricular pressure is still greater than atrial pressure. This is isovolumetric relaxation. Atrial pressure continues to rise because of venous return, with the v wave of the JVP waveform peaking during this phase. Rapid flow of blood from the atria into the ventricles during the ventricular filling phase causes thethird heart sound, which is normal in children but, in adults, is associated with disease such as ventricular dilation.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 14
Incorrect
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Where on the body is the radial artery pulsation best palpated?
Your Answer:
Correct Answer: At the wrist just lateral to the flexor carpi radialis tendon
Explanation:The radial artery lies lateral to the large tendon of the flexor carpi radialis muscle and anterior to the pronator quadratus at the distal end of the radius. The flexor carpi radialis muscle is used as a landmark in locating the pulse.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 15
Incorrect
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A patient presents with a lump for a dermatological examination. There is a circumscribed skin elevation measuring 0.3 cm in diameter seen on examination.Which one of these best describes the lump you have found on examination?
Your Answer:
Correct Answer: Papule
Explanation:A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter. A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless. A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter. A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus. A pustule is a small visible skin elevation containing an accumulation of pus.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 16
Incorrect
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You are about to perform a blood test on a patient suspected of having systemic lupus erythematosus. Which antibodies will indicate a positive result of systemic lupus erythematosus?
Your Answer:
Correct Answer: Anti-nuclear antibodies
Explanation:Antinuclear antibodies (ANA) are autoantibodies to the cells’ nucleus. The ANA test is the most sensitive diagnostic test for verifying the disease’s diagnosis. Other autoantibodies that may be found in SLE patients include rheumatoid factor, antiphospholipid antibodies, and antimitochondrial antibodies.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 17
Incorrect
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Diabetic ketoacidosis is characterised by which of the following:
Your Answer:
Correct Answer: Hyperglycaemia, ketonaemia and acidosis
Explanation:DKA is characterised by the biochemical triad:1. Hyperglycaemia (> 11 mmol/L)2. Ketonaemia (> 3 mmol/L)3. Acidosis (pH < 7.3 +/- HCO3 < 15 mmol/L)
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This question is part of the following fields:
- Endocrine
- Physiology
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Question 18
Incorrect
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A 55-year-old male diabetic patient presents to the Emergency Room complaining of severe chest pain. His medical record shows that he had coronary angioplasty one week ago, during which he was administered abciximab. Which of the following haematological diseases has a similar mechanism of action to this drug?
Your Answer:
Correct Answer: Glanzmann’s thrombasthenia
Explanation:Abciximab is glycoprotein IIb/IIIa receptor antagonist that decreases aggregation of platelets by prevent their cross-linking. In Glanzmann’s thrombasthenia there are low levels of these same receptors leading to decreased bridging of platelets as fibrinogen cannot attach. There is increased bleeding time both in this disease and when there is use of abciximab.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 19
Incorrect
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Regarding endothelin-1, which of the following statements is INCORRECT:
Your Answer:
Correct Answer: Endothelin-1 release is inhibited by noradrenaline.
Explanation:Endothelin-1 (ET-1) is an extremely potent vasoconstrictor peptide which is released from the endothelium in the presence of many other vasoconstrictors, including angiotensin II, antidiuretic hormone (ADH) and noradrenaline, and may be increased in disease and hypoxia.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 20
Incorrect
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Cardiac myocytes are connected to each other by which of the following:
Your Answer:
Correct Answer: Intercalated discs
Explanation:Adjacent cardiac myocytes are connected to each other by intercalated discs. The intercalated discs provide both a structural attachment by ‘glueing’ cells together at desmosomes and an electrical contact made up of proteins called connexons, called a gap junction, which essentially creates a low-resistance pathway between cells.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 21
Incorrect
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When treating diabetic ketoacidosis (DKA), which of the following should be given if the systolic blood pressure is initially less than 90 mmHg:
Your Answer:
Correct Answer: 500 mL sodium chloride 0.9% intravenous infusion over 10 - 15 minutes
Explanation:If SBP is less than 90 mmHg , 500 mL sodium chloride 0.9 percent should be administered intravenously over 10–15 minutes, and repeated if SBP remains less than 90 mmHg. When SBP is greater than 90 mmHg, sodium chloride infusion must be maintained at a rate that replaces the deficit.
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This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 22
Incorrect
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Which of the following decreases activation of vitamin D:
Your Answer:
Correct Answer: Chronic renal failure
Explanation:Calcium deficiency (low Ca2+ diet or hypocalcemia) activates 1-alpha-hydroxylase in the cells of the renal proximal tubule which catalyses the conversion of vitamin D to its active form, 1,25-dihydroxycholecalciferol. Increased parathyroid hormone (PTH) and hypophosphatemia also stimulate the enzyme. Chronic renal failure is associated with a constellation of bone diseases, including osteomalacia caused by failure of the diseased renal tissue to produce the active form of vitamin D.
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This question is part of the following fields:
- Endocrine
- Physiology
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Question 23
Incorrect
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You're a member of the cardiac arrest team, and you're helping to resuscitate an elderly gentleman who had collapsed at home. The team leader requests that you administer an adrenaline shot.Which of the following statements about adrenaline is FALSE?
Your Answer:
Correct Answer: The IM dose in anaphylaxis is 1 ml of 1:1000
Explanation:Adrenaline (epinephrine) is a sympathomimetic amine that binds to alpha- and beta-adrenergic receptors and acts as an agonist. It is active at both alpha and beta receptors in roughly equal amounts.When taken orally, it becomes inactive. Subcutaneous absorption is slower than intramuscular absorption. In cardiac arrest, it is well absorbed from the tracheal mucosa and can be given through an endotracheal tube.At the adrenergic synapse, catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO) metabolise it primarily. The inactive products are then passed through the kidneys and excreted in the urine.In adult cardiac arrest, the IV dose is 1 mg, which is equal to 10 ml of 1:10000 or 1 ml of 1:1000. In anaphylaxis, the IM dose is 0.5 ml of 1:1000. (500 mcg).In open-angle glaucoma, adrenaline causes mydriasis and lowers pressure.Adrenaline is used in cardiopulmonary resuscitation, the treatment of severe croup, and the emergency management of acute allergic and anaphylactic reactions (as a nebuliser solution).
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 24
Incorrect
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Which of the following is NOT a typical cerebellar sign:
Your Answer:
Correct Answer: Resting tremor
Explanation:An intention tremor is characteristic of cerebellar dysfunction. Resting tremor may be seen in Parkinsonism.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 25
Incorrect
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Which of the following ions normally has the highest concentration in intracellular fluid:
Your Answer:
Correct Answer: K +
Explanation:Potassium (K+) is the principal intracellular ion; approximately 4 mmol/L is extracellular (3%) and 140 mmol/L intracellular (97%).
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This question is part of the following fields:
- Basic Cellular
- Physiology
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Question 26
Incorrect
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Which of the following is most likely affected in De Quervain's tenosynovitis?
Your Answer:
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.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 27
Incorrect
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Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or rectosigmoid should be treated initially with:
Your Answer:
Correct Answer: Local aminosalicylate
Explanation:Acute mild to moderate disease affecting the rectum (proctitis) or the rectosigmoid is treated initially with local application of an aminosalicylate; alternatively, a local corticosteroid can be used but it is less effective. A combination of a local aminosalicylate and a local corticosteroid can be used for proctitis that does not respond to a local aminosalicylate alone.
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This question is part of the following fields:
- Gastrointestinal
- Pharmacology
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Question 28
Incorrect
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Regarding relationships between two variables, what does a negative correlation coefficient indicate:
Your Answer:
Correct Answer: The two variables are inversely related
Explanation:A negative correlation coefficient means that the two variables are inversely related e.g. socio-economic class and mortality.
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 29
Incorrect
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A 73-year-old woman arrives at the emergency department 48 hours after being discharged from the hospital after a two-week stay for sepsis treatment. She has fever, productive cough with thick green sputum, and shortness of breath. An X-ray shows left lower lobe pneumonia. Which of the bacteria listed below is more likely to be the causative agent:
Your Answer:
Correct Answer: Pseudomonas aeruginosa
Explanation:Hospital-acquired pneumonia (HAP), or nosocomial pneumonia, is a lower respiratory infection that was not incubating at the time of hospital admission and that presents clinically 2 or more days after hospitalization. Pneumonia that presents sooner should be regarded as community acquired pneumonia. VAP refers to nosocomial pneumonia that develops among patients on ventilators. Ventilator-associated pneumonia (VAP) is defined as pneumonia that presents more than 48 hours after endotracheal intubation.Common bacteria involved in hospital-acquired pneumonia (HAP) include the following [10] :Pseudomonas AeruginosaStaphylococcus aureus, including methicillin-susceptible S aureus (MSSA) and methicillin-resistant S aureus (MRSA)Klebsiella pneumoniaeEscherichia coli
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This question is part of the following fields:
- Infections
- Microbiology
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Question 30
Incorrect
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Which of the following does NOT predispose to digoxin toxicity in a patient taking digoxin:
Your Answer:
Correct Answer: Hyponatraemia
Explanation:Hypoxia, hypercalcaemia, hypokalaemia and hypomagnesaemia predispose to digoxin toxicity. Care should also be taken in the elderly who are particularly susceptible to digoxin toxicity. Hypokalaemia may be precipitated by use of diuretics. Although hyponatremia can result in the development of other pathological disturbances, it does not potentiate digoxin toxicity.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
