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  • Question 1 - A 30-year-old man bought into the ED with increased thirst, confusion, abdominal pain...

    Incorrect

    • A 30-year-old man bought into the ED with increased thirst, confusion, abdominal pain and constipation is suspected to have hypercalcaemia.What is the commonest cause of hypercalcaemia in the UK?

      Your Answer: Secondary hyperparathyroidism

      Correct Answer: Primary hyperparathyroidism

      Explanation:

      The commonest cause of hypercalcaemia in the UK is primary hyperparathyroidism, which accounts for around 70-80% of cases. It is commoner in younger patients and in community setting.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      27.8
      Seconds
  • Question 2 - Regarding forest plots, which of the following is the purpose of this graph?...

    Correct

    • Regarding forest plots, which of the following is the purpose of this graph?

      Your Answer: To graphically display the relative strength of multiple studies attempting to answer the same question

      Explanation:

      The results of meta-analysis are often displayed graphically in a forest plot. A properly constructed forest plot is the most effective way to graphically display the relative strength of multiple studies attempting to answer the same question. A typical meta-analysis consists of three main objectives that include estimation of effect sizes from individual studies and a pooled summary estimate with their confidence intervals (CIs), heterogeneity among the studies, and any publication bias. The forest plot illustrates the first two of these objectives. Forest plots visualize the effect measure and CI of individual studies, which provide the raw data for the meta-analysis, as well the pooled-effect measure and CI. The individual studies also can be grouped in the forest plot by some of their characteristics for ease of interpretation such as by study size or year of publication. When comparing the outcomes between an intervention and a control group, dichotomous outcome variables are expressed as ratios (i.e. odds ratios, ORs or risk ratios, RRs), while for continuous outcomes, a weighted mean difference is reported.

    • This question is part of the following fields:

      • Evidence Based Medicine
      19.9
      Seconds
  • Question 3 - Which of the following is NOT a benefit of low molecular weight heparin...

    Incorrect

    • Which of the following is NOT a benefit of low molecular weight heparin (LMWH) over unfractionated heparin therapy:

      Your Answer: It has a lower associated risk of osteoporosis.

      Correct Answer: Its effects can be rapidly and completely reversed with protamine sulfate.

      Explanation:

      Advantages of LMWHGreater ability to inhibit factor Xa directly, interacting less with platelets and so may have a lesser tendency to cause bleedingGreater bioavailability and longer half-life in plasma making once daily subcutaneous administration possibleMore predictable dose response avoiding the need for routine anticoagulant monitoringLower associated risk of heparin-induced thrombocytopenia or of osteoporosis

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      84.2
      Seconds
  • Question 4 - Diabetic ketoacidosis is characterised by which of the following: ...

    Correct

    • Diabetic ketoacidosis is characterised by which of the following:

      Your 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)

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      13.6
      Seconds
  • Question 5 - 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
      10.8
      Seconds
  • Question 6 - A 18-year-old man returns from a trip to Ibiza with a severely painful...

    Incorrect

    • A 18-year-old man returns from a trip to Ibiza with a severely painful left eye. He has copious mucopurulent discharge, is febrile and has left-sided tender preauricular lymphadenopathy. He attends the local eye casualty and is diagnosed with hyperacute conjunctivitis.What is the SINGLE most likely causatiave organism?

      Your Answer: Chlamydia trachomatis

      Correct Answer: Neisseria gonorrhoeae

      Explanation:

      Hyperacute bacterial conjunctivitis is a severe, sight-threatening ocular infection that warrants immediate ophthalmic work-up and management. The infection has an abrupt onset and is characterized by a copious yellow-green purulent discharge that reaccumulates after being wiped away. Typically caused by infection with Neisseria gonorrhoeae.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      99.3
      Seconds
  • Question 7 - A 65-year-old man presents with cough and shortness of breath. His sputum is...

    Correct

    • A 65-year-old man presents with cough and shortness of breath. His sputum is rusty in colour and is suffering from a fever. Upon examination, it was noted that he has crackles in the right upper lobe. A chest X-ray showed the presence of a right upper lobe cavitation.Among the following microorganisms, which is considered to be mostly associated with a cavitating upper lobe pneumonia?

      Your Answer: Klebsiella pneumoniae

      Explanation:

      Klebsiella pneumoniae is among the most common Gram-negative bacteria encountered by physicians worldwide and accounts for 0.5-5.0% of all cases of pneumonia. This organism can cause extensive pulmonary necrosis and frequent cavitation.It is one of the causes that could be suspected when there is cavitatory pneumonia with or without a bulging fissure sign. Often, there can be extensive lobar opacification with air bronchograms.A helpful feature which may help to distinguish from pneumococcal pneumonia is that Klebsiella pneumoniae develops cavitation in 30-50% of cases (in comparison, cavitation is rare in pneumococcal pneumonia). This occurs early and progresses quickly.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      21.1
      Seconds
  • Question 8 - Which of the following statements accurately describes the extensor indicis muscle? ...

    Incorrect

    • Which of the following statements accurately describes the extensor indicis muscle?

      Your Answer: It is innervated by the median nerve

      Correct Answer: It lacks the juncturae tendinum

      Explanation:

      Extensor indicis is a narrow, elongated muscle found in the posterior compartment of the forearm. It belongs to the deep extensors of the forearm, together with supinator, abductor pollicis longus, extensor pollicis longus, and extensor pollicis brevis muscles. It lacks the juncturae tendinum, which connects the extensor digitorum on the dorsal aspect of the hand.Extensor indicis can be palpated by applying deep pressure over the lower part of the ulna while the index finger is extended. The main function of extensor indicis involves the extension of the index finger at the metacarpophalangeal and interphalangeal joints. As the index finger is one of the few fingers that have their own separate extensor muscle, it is able to extend independently from other fingers. Additionally, extensor indicis muscle produces a weak extension of the wrist.Extensor indicis receives its nervous supply from posterior interosseous nerve, a branch of the radial nerve derived from spinal roots C7 and C8. The skin overlying the muscle is supplied by the same nerve, with fibres that stem from the spinal roots C6 and C7.The superficial surface of the extensor indicis receives arterial blood supply from posterior interosseous branch of the ulnar artery, whereas its deep surface receives blood from perforating branches of the anterior interosseous artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      43
      Seconds
  • Question 9 - Regarding the resting membrane potential, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the resting membrane potential, which of the following statements is CORRECT:

      Your Answer: A neurone has a resting membrane potential of about -90 mV.

      Correct Answer: The resting cell membrane is more permeable to K + ions than to Na + ions.

      Explanation:

      A membrane potential is a property of all cell membranes, but the ability to generate an action potential is only a property of excitable tissues. The resting membrane is more permeable to K+and Cl-than to other ions (and relatively impermeable to Na+); therefore the resting membrane potential is primarily determined by the K+equilibrium potential. At rest the inside of the cell is negative relative to the outside. In most neurones the resting potential has a value of approximately -70 mV.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      26.3
      Seconds
  • Question 10 - You review a patient with urinary sepsis and decide to start her on...

    Correct

    • You review a patient with urinary sepsis and decide to start her on gentamicin.Which statement about gentamicin is true?

      Your Answer: Ototoxicity is a dose-related effect

      Explanation:

      Gentamicin, an aminoglycoside antibiotic, acts by binding to the 30S subunit of the bacterial ribosome inhibiting the binding of aminoacyl-tRNA, and thus prevents initiation of protein synthesis.Gentamicin is given by injection because it is NOT absorbed orally. It is excreted in the kidneys by glomerular filtrationGentamicin is not to be used for the treatment of Neisseria meningitidis, Neisseria gonorrhoea, or Legionella pneumophila.There is a risk of patient going into shock from lipid A endotoxin release.Two of its most notable side effects are hearing loss reversible nephrotoxicity and which are both dose-related and levels should be monitored in patients.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      41.9
      Seconds
  • Question 11 - Which of the following nerves has been damaged when a patient presents with...

    Correct

    • Which of the following nerves has been damaged when a patient presents with a foot drop?

      Your Answer: Common peroneal nerve

      Explanation:

      The common peroneal nerve often referred to as the common fibular nerve, is a major nerve that innervates the lower extremity. It is one of the two major branches off the sciatic nerve and receives fibres from the posterior divisions of L4 through S2 nerve roots. The common peroneal nerve separates from the sciatic nerve in the distal posterior thigh proximal to the popliteal fossa. After branching off of the sciatic nerve, it continues down the thigh, running posteroinferior to the biceps femoris muscle, and crosses laterally to the head of the lateral gastrocnemius muscle through the posterior intermuscular septum. The nerve then curves around the fibular neck before dividing into two branches, the superficial peroneal nerve (SPN) and the deep peroneal nerve (DPN). The common peroneal nerve does not have any motor innervation before dividing; however, it provides sensory innervation to the lateral leg via the lateral sural nerve.The superficial peroneal nerve innervates the lateral compartment of the leg, and the deep peroneal nerve innervates the anterior compartment of the leg and the dorsum of the foot. These two nerves are essential in the eversion of the foot and dorsiflexion of the foot, respectively. The superficial and deep peroneal nerves provide both motor and sensory innervation.The most common presentation with common peroneal nerve injury or palsy is acute foot drop, although symptoms may be progressive and can include sensory loss or pain. Weakness in foot eversion may occur if the superficial peroneal nerve component is involved.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      51
      Seconds
  • Question 12 - The renal corpuscle, consisting of the Bowman's capsule and the glomerulus is found...

    Incorrect

    • The renal corpuscle, consisting of the Bowman's capsule and the glomerulus is found where in the kidney:

      Your Answer: The medulla

      Correct Answer: The cortex

      Explanation:

      All nephrons have their renal corpuscles in the renal cortex. Cortical nephrons have their renal corpuscles in the outer part of the cortex and relatively short loops of Henle. Juxtamedullary nephrons have their corpuscles in the inner third of the cortex, close to the corticomedullary junction, with long loops of Henle extending into the renal medulla.

    • This question is part of the following fields:

      • Physiology
      • Renal
      44.1
      Seconds
  • Question 13 - You plan to use plain 1% lidocaine for a ring block on a...

    Incorrect

    • You plan to use plain 1% lidocaine for a ring block on a finger that needs suturing.Which SINGLE statement regarding the use of 1% lidocaine, in this case, is true?

      Your Answer: The maximum safe dose of plain lidocaine alone is 7 mg/kg

      Correct Answer: Lidocaine works by blocking fast voltage-gated sodium channels

      Explanation:

      Lidocaine is a tertiary amine that is primarily used as a local anaesthetic but can also be used intravenously in the treatment of ventricular dysrhythmias.Lidocaine works as a local anaesthetic by diffusing in its uncharged base form through neural sheaths and the axonal membrane to the internal surface of the cell membrane sodium channels. Here it alters signal conduction by blocking the fast voltage-gated sodium channels. With sufficient blockage, the membrane of the postsynaptic neuron will not depolarise and will be unable to transmit an action potential, thereby preventing the transmission of pain signals.Each 1 ml of plain 1% lidocaine solution contains 10 mg of lidocaine hydrochloride. The maximum safe dose of plain lidocaine is 3 mg/kg. When administered with adrenaline 1:200,000, the maximum safe dose is 7 mg/kg. Because of the risk of vasoconstriction and tissue necrosis, lidocaine should not be used in combination with adrenaline in extremities such as fingers, toes, and the nose.The half-life of lidocaine is 1.5-2 hours. Its onset of action is rapid within a few minutes, and it has a duration of action of 30-60 minutes when used alone. Its duration of action is prolonged by co-administration with adrenaline (about 90 minutes).Lidocaine tends to cause vasodilatation when used locally. This is believed to be due mainly to the inhibition of action potentials via sodium channel blocking in vasoconstrictor sympathetic nerves.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      78.9
      Seconds
  • Question 14 - A thyroid function test is done for a 55-year-old woman with non-specific symptoms,...

    Incorrect

    • A thyroid function test is done for a 55-year-old woman with non-specific symptoms, the results are shown below:TSH = 5.2Free T4 is normalFree T3 is normalThe most likely diagnosis in this patient is?

      Your Answer: Secondary hypothyroidism

      Correct Answer: Subclinical hypothyroidism

      Explanation:

      Hypothyroidism is diagnosed using the results of thyroid function tests (TFTs). In the early stages of the disease, the earliest biochemical change noticed is a rise in thyroid-stimulating hormone (TSH) levels. Free triiodothyronine (T3) and thyroxine (T4) levels are usually normal.In primary hypothyroidism, the serum TSH level is usually greater than 10 mU/L, and free T4 levels are below the reference range.Subclinical hypothyroidism is diagnosed when the serum TSH level is above the reference range, and the free T4 levels are within the reference range. The test should, however, be repeated after 3-6 months to exclude transient causes of raised TSH.In summary, how to interpret TFTs in cases of suspected hypothyroidism is shown below:Subclinical hypothyroidismTSH is raisedFree T4 is normalFree T3 is normalPrimary hypothyroidismTSH is raisedFree T4 is loweredFree T3 is lowered or normalSecondary hypothyroidismTSH is lowered or normalFree T4 is loweredFree T3 is lowered or normal

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      51.9
      Seconds
  • Question 15 - Regarding macrolide antibiotics, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding macrolide antibiotics, which of the following statements is CORRECT:

      Your Answer: Macrolides interfere with bacterial DNA synthesis.

      Correct Answer: Macrolides are first line for treatment of whooping cough.

      Explanation:

      A macrolide antibiotic is recommended first line for whooping cough (if onset of cough is within the previous 21 days)Prescribe clarithromycin for infants less than 1 month of age.Prescribe azithromycin or clarithromycin for children aged 1 month or older, and non-pregnant adults.Prescribe erythromycin for pregnant women.Macrolides interfere with bacterial protein synthesis and are mainly active against Gram-positive organisms. They have a similar antibacterial spectrum to penicillin and are thus a useful alternative in penicillin-allergic patients. Erythromycin is commonly associated with gastrointestinal upset.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      13.9
      Seconds
  • Question 16 - A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a...

    Incorrect

    • A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a poor response and you administer another nebuliser with ipratropium bromide added on.Which statement about ipratropium bromide is true?

      Your Answer: It is a muscarinic agonist

      Correct Answer: It can trigger acute closed-angle glaucoma

      Explanation:

      Ipratropium bromide is an antimuscarinic drug. It is used in the management of acute asthma and COPD. It provides short-term relief in chronic asthma. Short-acting β2agonists are preferred and act more quickly.The commonest side effect of ipratropium bromide is dry mouth. Tremor is commonly seen with β2agonists. It can trigger acute closed-angle glaucoma in patients that are susceptible. First-line treatment for moderate asthma attacks is short-acting β2agonists.The BTS guidelines recommend that nebulised ipratropium bromide (0.5 mg 4-6 hourly) be added to β2agonist treatment in patients with a poor initial response to β2agonist therapy or with acute severe or life-threatening asthma.Its duration of action is 3-6 hours, maximum effect occurs 30-60 minutes after use, and bronchodilation can be maintained with three times per day dosing.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      24.8
      Seconds
  • Question 17 - Identify the type of graph described below:This graph is a useful tool for...

    Incorrect

    • Identify the type of graph described below:This graph is a useful tool for evaluating the performance of diagnostic tests and more generally for evaluating the accuracy of a statistical model (e.g., logistic regression, linear discriminant analysis) that classifies subjects into 1 of 2 categories, diseased or non diseased. The closer the graph is to the upper left corner, which represents 100% sensitivity and 100% specificity, the more accurate the diagnostic test.

      Your Answer:

      Correct Answer: ROC curve

      Explanation:

      Receiver-operating characteristic (ROC) analysis was originally developed during World War II to analyse classification accuracy in differentiating signal from noise in radar detection. Recently, the methodology has been adapted to several clinical areas heavily dependent on screening and diagnostic tests, in particular, laboratory testing, epidemiology, radiology, and bioinformatics. ROC analysis is a useful tool for evaluating the performance of diagnostic tests and more generally for evaluating the accuracy of a statistical model (e.g., logistic regression, linear discriminant analysis) that classifies subjects into 1 of 2 categories, diseased or non diseased. Its function as a simple graphical tool for displaying the accuracy of a medical diagnostic test is one of the most well-known applications of ROC curve analysis.The closer the ROC curve is to the upper left corner, which has 100% sensitivity and 100% specificity, the higher the overall accuracy of the diagnostic test.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds
  • Question 18 - Clostridium difficile primarily causes which of the following infectious diseases: ...

    Incorrect

    • Clostridium difficile primarily causes which of the following infectious diseases:

      Your Answer:

      Correct Answer: Pseudomembranous colitis

      Explanation:

      Clostridium difficile causes pseudomembranous colitis, an acute inflammatory diarrhoeal disease and an important cause of morbidity and mortality in hospitals. Gas gangrene is primarily caused by Clostridium perfringens. Tetanus is caused by Clostridium tetani. Toxic shock syndrome may be caused by Staphylococcus aureus or Streptococcus pyogenes. Necrotising fasciitis is most commonly caused by Streptococcus pyogenes but has a multitude of causes.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 19 - Regarding aspirin at analgesic doses, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding aspirin at analgesic doses, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: It is contraindicated in patients with severe heart failure.

      Explanation:

      Aspirin (at analgesic doses) is contraindicated in severe heart failure. Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes resulting in decreased production of prostaglandins (which can lead to irritation of the gastric mucosa). The analgesic dose is greater than the antiplatelet dose, and taken orally it has a duration of action of about 4 hours. Clinical features of salicylate toxicity in overdose include hyperventilation, tinnitus, deafness, vasodilatation, and sweating.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 20 - Regarding the factor V Leiden gene mutation, which of the following best describes...

    Incorrect

    • Regarding the factor V Leiden gene mutation, which of the following best describes the clinical effect:

      Your Answer:

      Correct Answer: It results in increased levels of activated factor V.

      Explanation:

      Factor V Leiden gene mutation is the most common inherited cause of an increased risk of venous thrombosis. Activated protein C normally breaks down activated factor V and so should slow the clotting reaction and prolong the APTT, but a mutation in the factor V gene makes factor V less susceptible to cleavage by activated protein C, resulting in increased levels of activated factor V.Heterozygotes for factor V Leiden are at an approximately five- to eight- fold increased risk of venous thrombosis compared to the general population (but only 10% of carriers will develop thrombosis in their lifetime). Homozygotes have a 30 – 140-fold increased risk. The incidence of factor V Leiden in patients with venous thrombosis is approximately 20 – 40%. It does not increase the risk of arterial thrombosis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 21 - A 66-year-old female presents to the Emergency Department with a nose bleed. She...

    Incorrect

    • A 66-year-old female presents to the Emergency Department with a nose bleed. She says that she has been having frequent episodes of nose bleeds over the past four months, along with increasing fatigue and some weight loss. On examination, she has a diffuse petechial rash and hypertrophy of the gingiva. Which one of the following conditions is this patient most likely to have?

      Your Answer:

      Correct Answer: Acute myeloid leukaemia (AML)

      Explanation:

      The history of nosebleeds and fatigue, and gingival hyperplasia presents a typical picture of acute myeloid leukaemia. Leukemic infiltrates within the gingiva cause hypertrophy and distinguish this condition from other types of leukaemia. The fatigue is secondary to anaemia, while the nosebleeds are caused by thrombocytopenia secondary to leukemic infiltration of bone marrow. Patients may also report frequent infections secondary to neutropenia and hepatosplenomegaly.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 22 - Which of the following ABO blood groups is the universal recipient: ...

    Incorrect

    • Which of the following ABO blood groups is the universal recipient:

      Your Answer:

      Correct Answer: AB

      Explanation:

      Blood group AB has both A and B antigens but no antibodies and thus is the universal recipient.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds
  • Question 23 - A 58-year-old man with a long history of poorly controlled hypertension complains of...

    Incorrect

    • A 58-year-old man with a long history of poorly controlled hypertension complains of a headache and vision blurring today. In triage, his blood pressure is 210/192 mmHg. A CT head scan is scheduled to rule out the possibility of an intracranial haemorrhage. You make the diagnosis of hypertensive encephalopathy and rush the patient to reus to begin blood pressure-lowering treatment. He has a history of brittle asthma, for which he has been admitted to the hospital twice in the last year.Which of the following is the patient's preferred drug treatment?

      Your Answer:

      Correct Answer: Nicardipine

      Explanation:

      End-organ damage (e.g. encephalopathy, intracranial haemorrhage, acute myocardial infarction or ischaemia, dissection, pulmonary oedema, nephropathy, eclampsia, papilledema, and/or angiopathic haemolytic anaemia) characterises a hypertensive emergency (also known as ‘accelerated hypertension’ or malignant hypertension’ It’s a life-threatening condition that necessitates rapid blood pressure reduction to avoid end-organ damage and a negative outcome.Hypertensive encephalopathy is a syndrome that includes headaches, seizures, visual changes, and other neurologic symptoms in people who have high blood pressure. It is reversible if treated quickly, but it can progress to coma and death if not treated properly.Any patient with suspected hypertensive encephalopathy should have an urgent CT scan to rule out an intracranial haemorrhage, as rapid blood pressure reduction could be dangerous in these circumstances.The drug of choice is labetalol, which reduces blood pressure steadily and consistently without compromising cerebral blood flow.An initial reduction of approximately 25% in mean arterial pressure (MAP) over an hour should be aimed for, followed by a further controlled MAP reduction over the next 24 hours. In patients who are unable to take beta-blockers, nicardipine can be used as a substitute.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 24 - What is the main mechanism of action of cyclizine: ...

    Incorrect

    • What is the main mechanism of action of cyclizine:

      Your Answer:

      Correct Answer: Histamine-H1 antagonist

      Explanation:

      Antihistamines e.g. cyclizine, are effective against nausea and vomiting caused by many different conditions, including motion sickness and vertigo. These agents act by inhibiting histamine pathways, and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. There is no evidence that any one antihistamine is superior to another but their duration of action and incidence of adverse effects differ. Adverse effects include drowsiness and antimuscarinic effects such as blurred vision, dry mouth, urinary retention, constipation and confusion.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 25 - A patient presents with a laceration on his hand and wrist that has...

    Incorrect

    • A patient presents with a laceration on his hand and wrist that has cut the nerve that innervates opponens pollicis.The opponens pollicis muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer:

      Correct Answer: The recurrent branch of the median nerve

      Explanation:

      Opponens pollicis is a small, triangular muscle that forms part of the thenar eminence. It originates from the flexor retinaculum and the tubercle of trapezium bone and inserts into the whole length of the first metacarpal bone on its radial side.Opponens pollicis is innervated by the recurrent branch of the median nerve and receives its blood supply from the superficial palmar arch.The main action of opponens pollicis is to flex the first metacarpal bone at the carpometacarpal joint, which opposes the thumb towards the centre of the palm. It also medially rotates the first metacarpal bone at the carpometacarpal joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 26 - A 58-year-old patient presents with sputum production and worsening exertional breathlessness. A spirometry...

    Incorrect

    • A 58-year-old patient presents with sputum production and worsening exertional breathlessness. A spirometry is done and his results leads to a diagnosis of obstructive lung disease with mild airflow obstruction.What FEV1 value would correspond with mild airflow obstruction according to the NICE guidelines?

      Your Answer:

      Correct Answer: FEV 1 >80%

      Explanation:

      Airflow obstruction according to the latest NICE guidelines, is defined as: Mild airflow obstruction = an FEV 1 of >80% in the presence of symptoms Moderate airflow obstruction = FEV 1 of 50-79% Severe airflow obstruction = FEV 1 of 30-49% Very severe airflow obstruction = FEV1<30%.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      0
      Seconds
  • Question 27 - Regarding T helper cells, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding T helper cells, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: They form the vast majority (about 75%) of the total circulating T-cell population.

      Explanation:

      CD4+ T-cells (Helper T cells)Recognise antigen only in association with HLA class II molecules (found on antigen presenting cells (APCs) e.g. dendritic cells, B-cells; present exogenous antigens that have been phagocytosed/endocytosed into intracellular vesicles)Form most of the circulating T-cell population (about 75%)Secrete cytokines (e.g. IFN-gamma) which are required for recruitment and activation of other immune cells such as macrophages, T cytotoxic cells and NK cells and for the activation of and production of immunoglobulin from B-cells

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds
  • Question 28 - Which of the following is NOT a common side effect of antihistamines: ...

    Incorrect

    • Which of the following is NOT a common side effect of antihistamines:

      Your Answer:

      Correct Answer: Tremor

      Explanation:

      Common side effects of antihistamines may include:Anticholinergic effects (blurred vision, dry mouth, urinary retention)HeadacheGastrointestinal disturbancesPsychomotor impairment (sedation, dizziness and loss of appetite)These side effects are significantly reduced with second-generation agents.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      0
      Seconds
  • Question 29 - In the Kaplan-Meier plot, which of the following labels should be applied to...

    Incorrect

    • In the Kaplan-Meier plot, which of the following labels should be applied to the X-axis?

      Your Answer:

      Correct Answer: Time in years

      Explanation:

      Kaplan-Meier estimate is one of the best options to be used to measure the fraction of subjects living for a certain amount of time after treatment. In clinical trials or community trials, the effect of an intervention is assessed by measuring the number of subjects survived or saved after that intervention over a period of time. The time starting from a defined point to the occurrence of a given event, for example death, is called as survival time and the analysis of group data as survival analysis. The graph plotted between estimated survival probabilities/estimated survival percentages (on Y axis) and time past after entry into the study (on X axis) consists of horizontal and vertical lines.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds
  • Question 30 - A 50-year-old man from Russia presents with a history of cough with blood-stained...

    Incorrect

    • A 50-year-old man from Russia presents with a history of cough with blood-stained sputum, fever, night sweats, and weight loss. Suspecting tuberculosis, you begin investigations.All the following statements regarding tuberculosis (TB) are true EXCEPT?

      Your Answer:

      Correct Answer: Corticosteroid use is not a risk factor for developing TB

      Explanation:

      Immunosuppressants like corticosteroids may be an important risk factor for developing tuberculosis. All of the other statements are true.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrine Physiology (0/2) 0%
Physiology (1/5) 20%
Evidence Based Medicine (1/1) 100%
Cardiovascular (1/2) 50%
Pharmacology (2/6) 33%
Endocrine (1/1) 100%
Microbiology (1/2) 50%
Specific Pathogen Groups (1/2) 50%
Anatomy (1/2) 50%
Upper Limb (0/1) 0%
Basic Cellular (0/1) 0%
Infections (1/2) 50%
Lower Limb (1/1) 100%
Renal (0/1) 0%
Anaesthesia (0/1) 0%
Respiratory Pharmacology (0/1) 0%
Passmed