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  • Question 1 - You have been asked to give a tutorial on common upper limb neurology...

    Correct

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

      Your Answer: Weakness of forearm pronation

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      56.5
      Seconds
  • Question 2 - A 26-year-old woman is currently 9 weeks pregnant. Upon interview and history taking,...

    Correct

    • A 26-year-old woman is currently 9 weeks pregnant. Upon interview and history taking, she mentioned that she visited a friend whose child had just been diagnosed with slapped cheek disease.If the mother contracts an illness during pregnancy, which among the following is not known to cause fetal abnormalities?

      Your Answer: Hepatitis A

      Explanation:

      Hepatitis A usually doesn’t pose a special risk to a pregnant woman or her baby. Maternal infection doesn’t result in birth defects, and a mother typically doesn’t transmit the infection to her baby. HAV is almost always transmitted by the faecal-oral route and is usually acquired through close personal contact or via contaminated food.When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes scars, defects of muscle and bone, malformed and paralyzed limbs, small head size, blindness, seizures, and intellectual disability.TORCH Syndrome refers to infection of a developing foetus or newborn by any of a group of infectious agents. “TORCH” is an acronym meaning (T)toxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex.Infection with any of these agents may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and other symptoms and findings.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      22.5
      Seconds
  • Question 3 - You're called to a cardiac arrest in your Emergency Department resuscitation area. The...

    Incorrect

    • You're called to a cardiac arrest in your Emergency Department resuscitation area. The rhythm strip is shown in the diagram below. Defibrillation has already been attempted three times on the patient. You intended to administer amiodarone, but your department has informed you that it is not available.In these circumstances, if amiodarone is not available, which of the following drugs is recommended by the ALS guidelines?

      Your Answer: Digoxin

      Correct Answer: Lidocaine

      Explanation:

      If amiodarone is unavailable in VF/pVT arrests, lidocaine at a dose of 1 mg/kg can be used instead, according to the latest ALS guidelines. If amiodarone has already been given, no lidocaine should be given.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      22.5
      Seconds
  • Question 4 - A 15-year-old male is admitted to a rehabilitation centre with a history of...

    Correct

    • A 15-year-old male is admitted to a rehabilitation centre with a history of multiple strokes, myopathy and learning disabilities since childhood. He is under the care of a multidisciplinary team, and his genetic testing reports show the presence of a mitochondrial disorder. Which one of the following diseases does this patient most likely have?

      Your Answer: MELAS

      Explanation:

      Mitochondrial diseases are a group of disorders caused by dysfunctional mitochondria. Most cases are maternally inherited, as we inherit our mitochondrial DNA from our mothers only, although mutations in nuclear DNA cause some cases.Examples of Mitochondrial Diseases include:1. Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS)2. Mitochondrial epilepsy with ragged red fibres (MERRF)3. Leber’s hereditary optic neuropathy (LHON)4. Diabetes mellitus and deafness (DAD)5. Neuropathy, ataxia, retinitis pigmentosa, and ptosis (NARP)6. Leigh syndrome (subacute sclerosing encephalopathy). Red-green colour blindness and G6PD deficiency have an X-linked recessive pattern of inheritance. Tay-Sachs Disease and spinal muscular atrophy have an autosomal recessive pattern of inheritance.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      24.2
      Seconds
  • Question 5 - Myocardial contractility is best correlated with the intracellular concentration of: ...

    Incorrect

    • Myocardial contractility is best correlated with the intracellular concentration of:

      Your Answer: Na+

      Correct Answer: Ca2+

      Explanation:

      Contractility of myocardial cells depends on the intracellular [Ca2+], which is regulated by Ca2+entry across the cell membrane during the plateau of the action potential and by Ca2+uptake into and release from the sarcoplasmic reticulum (SR).

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      22.7
      Seconds
  • Question 6 - A 24-year-old waiter cuts his hand on a dropped plate that smashed and...

    Correct

    • A 24-year-old waiter cuts his hand on a dropped plate that smashed and damages the nerve that innervates opponens digiti minimi.The opponens digiti minimi muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: The deep branch of the ulnar nerve

      Explanation:

      Opponens digiti minimi is a triangular-shaped muscle in the hand that forms part of the hypothenar eminence. It originates from the hook of the hamate bone and the flexor retinaculum and inserts into the medial border of the 5thmetacarpal.Opponens digiti minimi is innervated by the deep branch of the ulnar nerve and receives its blood supply from the ulnar artery.Opponens digiti minimi draws the fifth metacarpal bone anteriorly and rotates it, bringing the fifth digiti into opposition with the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      5.4
      Seconds
  • Question 7 - Which of the following does NOT predispose to digoxin toxicity in a patient...

    Incorrect

    • Which of the following does NOT predispose to digoxin toxicity in a patient taking digoxin:

      Your Answer: Hypercalcaemia

      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.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      43.4
      Seconds
  • Question 8 - 1-alpha-hydroxylase is a cytochrome p450 enzyme that is involved in the production of...

    Incorrect

    • 1-alpha-hydroxylase is a cytochrome p450 enzyme that is involved in the production of vitamin D's hormonally active metabolite.Which of the following promotes the activity of 1-alpha-hydroxylase?

      Your Answer: Growth hormone

      Correct Answer: Parathyroid hormone

      Explanation:

      1-alpha-hydroxylase converts 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol in the kidney.The key regulatory point in the formation of 1,25-dihydroxycholecalciferol is 1-alpha-hydroxylase, which is promoted by parathyroid hormone or hypophosphatemia.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      16.5
      Seconds
  • Question 9 - A 32-year-old female is diagnosed case of bipolar disorder and is on medication....

    Correct

    • A 32-year-old female is diagnosed case of bipolar disorder and is on medication. She presents to her psychiatric team with symptoms of severe depression. She is currently taking Lithium. Out of the following, which is TRUE regarding lithium?

      Your Answer: It commonly causes a tremor

      Explanation:

      Lithium is the drug of choice for bipolar disorders but is commonly associated with side effects and toxicity. Fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy with Lithium. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer. Lithium tremors are more common with older age, presumably due to the additive effects of age-related essential tremors.Option The normal therapeutic range is 2.0-2.5 mmol/l: Lithium should be carefully monitored as it has a very low therapeutic index. The normal therapeutic range is 0.4-0.8 mmol/l. Levels should be checked one week after starting therapy and one week after every change in dosage. (Option Levels should be checked one month after starting therapy) Option It can induce hyperthyroidism: Lithium has a known effect on thyroid function. Lithium decreases the production of T4 and T3 and commonly causes hypothyroidism. More rarely, lithium causes hyperthyroidism due to thyroiditis.Option It can induce diabetes mellitus: Lithium can induce nephrogenic diabetes insipidus but not diabetes mellitus.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      38.6
      Seconds
  • Question 10 - A 45-year-old woman presents with persistent palpitations for the past two days. She...

    Incorrect

    • A 45-year-old woman presents with persistent palpitations for the past two days. She has a good haemodynamic balance. An ECG is performed, which reveals that she has atrial flutter. The patient is examined by a cardiology registrar, who recommends using a 'rate control' strategy while she waits for cardioversion.Which of the drugs listed below is the best fit for this strategy?

      Your Answer: Digoxin

      Correct Answer: Bisoprolol

      Explanation:

      In atrial flutter, ventricular rate control is usually used as a stopgap measure until sinus rhythm can be restored. A beta-blocker (such as bisoprolol), diltiazem, or verapamil can be used to lower the heart rate.Electrical cardioversion, pharmacological cardioversion, or catheter ablation can all be used to restore sinus rhythm. Cardioversion should not be attempted until the patient has been fully anticoagulated for at least three weeks if the duration of atrial flutter is unknown or has lasted for more than 48 hours. Emergency electrical cardioversion is the treatment of choice when there is an acute presentation with haemodynamic compromise. For the treatment of recurrent atrial flutter, catheter ablation is preferred.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      27.6
      Seconds
  • Question 11 - A 26-year-old male presents to your clinic with the complaint of recurrent fevers...

    Incorrect

    • A 26-year-old male presents to your clinic with the complaint of recurrent fevers over the past three months. On documentation of the fever, it is noted that the fever increases and decreases in a cyclical pattern over a 1-2 week period. After the appropriate investigations, a diagnosis of Pel-Ebstein fever is made. Which ONE of the following conditions is most likely to cause this patient's fever?

      Your Answer: Glandular fever

      Correct Answer: Hodgkin lymphoma

      Explanation:

      The release of cytokines from Reed-Sternberg cells can cause fever in patients with Hodgkin lymphoma, which increases and decreases in a cyclical pattern of 1 to 2 weeks. This is called Pel-Ebstein or Ebstein-Cardarelli fever, specifically seen in Hodgkin lymphoma. The fever is always high grade and can reach 40 degrees or higher.Cyclical fever in other conditions is common but is not termed as Pel-Ebstein fever. This term is reserved only with Hodgkin lymphoma.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      40.7
      Seconds
  • Question 12 - You are reviewing a patient following a fall from a horse. You suspect...

    Incorrect

    • You are reviewing a patient following a fall from a horse. You suspect they may have an Erb's palsy as a result of a brachial plexus injury. Regarding Erb's palsy, which one of the following statements is CORRECT:

      Your Answer: Erb's palsy characteristically results in Waiter's tip deformity where the arm is held in lateral rotation.

      Correct Answer: Erb's palsy may result in loss of sensation of the regimental badge area.

      Explanation:

      Erb’s palsy is caused by damage to the C5 and C6 nerve roots and thus primarily involves the musculocutaneous, suprascapular and axillary nerves. It commonly result from an excessive increase in the angle between the neck and the shoulder e.g. a person thrown from a motorbike or horseback or during a difficult birth. There is loss or weakness of abduction, lateral rotation and flexion of the arm and flexion and supination of the forearm and loss of sensation on the lateral arm. A characteristic ‘Waiter’s tip’ deformity may be present where the limb hangs limply by the side, medially rotated by the unopposed action of pectoralis major with the forearm pronated due to paralysis of the biceps brachii.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      21.1
      Seconds
  • Question 13 - Regarding a cohort study, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding a cohort study, which of the following statements is INCORRECT:

      Your Answer: It is prospective.

      Correct Answer: It is useful for rare diseases.

      Explanation:

      A cohort study is a longitudinal, prospective, observational study that follows a defined group (cohort) matched to unexposed controls for a set period of time and investigates the effect of exposure to a risk factor on a particular future outcome. The usual outcome measure is the relative risk (risk ratio). A large sample size is required for a rare outcome of interest so it is not useful for rare diseases.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      41.9
      Seconds
  • Question 14 - The resting membrane potential of a neurone is usually about: ...

    Incorrect

    • The resting membrane potential of a neurone is usually about:

      Your Answer: -30 mV

      Correct Answer: -70 mV

      Explanation:

      In most neurones the resting potential has a value of approximately -70 mV. The threshold potential is generally around -55 mV. Initial depolarisation occurs as a result of a Na+influx through ligand-gated Na+channels. Action potential is an all or nothing response; because the size of the action potential is constant, the intensity of the stimulus is coded by the frequency of firing of a neuron. Repolarisation occurs primarily due to K+efflux.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      53.2
      Seconds
  • Question 15 - Which of the following conditions manifests hyperkalaemia as one of its symptoms? ...

    Correct

    • Which of the following conditions manifests hyperkalaemia as one of its symptoms?

      Your Answer: Congenital adrenal hyperplasia

      Explanation:

      Plasma potassium greater than 5.5 mmol/L is hyperkalaemia or elevated plasma potassium level. Among the causes of hyperkalaemia include congenital adrenal hyperplasia. Congenital adrenal hyperplasia is a general term referring to autosomal recessive disorders involving a deficiency of an enzyme needed in cortisol and/or aldosterone synthesis. The level of cortisol and/or aldosterone deficiency affects the clinical manifestations of congenital adrenal hyperplasia. When it involves hypoaldosteronism, it can result in hyponatremia and hyperkalaemia. While hypercortisolism can cause hypoglycaemia.The other causes of hyperkalaemia may include renal failure, excess potassium supplementation, Addison’s disease (adrenal insufficiency), renal tubular acidosis (type 4), rhabdomyolysis, burns, trauma, Tumour lysis syndrome, acidosis, and medications such as ACE inhibitors, angiotensin receptor blockers, NSAIDs, beta-blockers, digoxin, and suxamethonium. Bartter’s syndrome is characterized by hypokalaemic alkalosis with normal to low blood pressure. Type 1 and 2 renal tubular acidosis both cause hypokalaemia. Gitelman’s syndrome is a defect of the distal convoluted tubule of the kidney. It causes metabolic alkalosis with hypokalaemia and hypomagnesemia. And excessive liquorice ingestion causes hypermineralocorticoidism and hypokalaemia as well. Thus, among the choices, only congenital adrenal hyperplasia can cause hyperkalaemia.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      7.8
      Seconds
  • Question 16 - A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve...

    Incorrect

    • A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve injury. Which of the following will confirm the presence of an ulnar nerve injury?

      Your Answer: Loss of flexion of the index and ring fingers

      Correct Answer: Claw hand appearance

      Explanation:

      An ulnar injury may result in abnormal sensations in the little finger and ring finger, usually on the palm side, weakness, and loss of coordination of the fingers. A claw like deformity of the hand and wrist is present. Pain, numbness, decreased sensation, tingling, or burning sensation in the areas controlled by the nerve are also possible.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      19.9
      Seconds
  • Question 17 - Carbon dioxide is transported in the blood approximately: ...

    Incorrect

    • Carbon dioxide is transported in the blood approximately:

      Your Answer: 60% as bicarbonate ions, 20% as carbamino compounds and 20% dissolved in plasma

      Correct Answer: 60% as bicarbonate ions, 30% as carbamino compounds and 10% dissolved in plasma.

      Explanation:

      Carbon dioxide is transported in the blood from tissues to the lungs in three ways as bicarbonate ions (60%), as carbamino compounds with proteins (30%) or simply dissolved in plasma (10%).

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      19.9
      Seconds
  • Question 18 - A 30-year-old male presents with easy bruising and bleeding gums, feeling very tired...

    Incorrect

    • A 30-year-old male presents with easy bruising and bleeding gums, feeling very tired lately, and recurrent chest infections over the past few months. He had glandular fever approximately 6 months ago and feels that his symptoms started after that. His full blood count today is as follows: Hb 6.3 g/dl (11.5-14 g/dl) MCV 90 fl (80-100 fl) WCC 2.0 x 10 9 /l (4-11 x 10 9 /l) Platelets 15 x 10 9 /l (150-450 x 10 9 /l)The SINGLE most likely diagnosis is?

      Your Answer: Iron deficiency anaemia

      Correct Answer: Aplastic anaemia

      Explanation:

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

    • This question is part of the following fields:

      • Haematology
      • Pathology
      21.5
      Seconds
  • Question 19 - Which of the following is NOT a characteristic of megaloblastic anaemia? ...

    Incorrect

    • Which of the following is NOT a characteristic of megaloblastic anaemia?

      Your Answer: Increased lactate dehydrogenase (LDH) level

      Correct Answer: Raised reticulocyte count

      Explanation:

      The LDH level is usually markedly increased in severe megaloblastic anaemia. Reticulocyte counts are inappropriately low, representing a lack of production of RBCs due to massive intramedullary haemolysis. These findings are characteristics of ineffective haematopoiesis that occurs in megaloblastic anaemia as well as in other disorders such as thalassemia major.The common feature in megaloblastosis is a defect in DNA synthesis in rapidly dividing cells. To a lesser extent, RNA and protein synthesis are impaired. Unbalanced cell growth and impaired cell division occur since nuclear maturation is arrested. More mature RBC precursors are destroyed in the bone marrow prior to entering the bloodstream (intramedullary haemolysis).

    • This question is part of the following fields:

      • Haematology
      • Pathology
      22.6
      Seconds
  • Question 20 - After collapsing in his nursing home, a 70-year-old man is brought into the...

    Incorrect

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

      Your Answer: Glucagon

      Correct Answer: Pioglitazone

      Explanation:

      Pioglitazone is used to treat type 2 diabetes mellitus. It selectively stimulates the nuclear receptor peroxisome proliferator-activated receptor gamma (PPAR-γ) and to a lesser extent PPAR-α. Of the medications mentioned in this question, only pioglitazone is a recognized cause of hypoglycaemia.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      22.6
      Seconds
  • Question 21 - Which of the following is NOT a feature characteristic of intravascular haemolysis: ...

    Correct

    • Which of the following is NOT a feature characteristic of intravascular haemolysis:

      Your Answer: Bilirubinuria

      Explanation:

      Features of intravascular haemolysis include:haemoglobinaemia, methaemalbuminaemia, haemoglobinuria (dark urine) and haemosiderinuria

    • This question is part of the following fields:

      • Haematology
      • Pathology
      28.8
      Seconds
  • Question 22 - A 28-year-old female patient with a history of hypothyroidism arrives at the Emergency...

    Incorrect

    • A 28-year-old female patient with a history of hypothyroidism arrives at the Emergency Department after taking 30 of her 200 mcg levothyroxine tablets. She tells you she's 'tired of life' and 'can't take it any longer.' She is currently asymptomatic, and her findings are all within normal limits.What is the minimum amount of levothyroxine that must be taken before thyrotoxicosis symptoms appear?

      Your Answer: >5 mg

      Correct Answer: >10 mg

      Explanation:

      An overdose of levothyroxine can happen by accident or on purpose. Intentional overdosing is sometimes done to lose weight, but it can also happen in patients who are suicidal. The development of thyrotoxicosis, which can lead to excited sympathetic activity and high metabolism syndrome, is the main source of concern. The time between ingestion and the emergence of clinical features associated with an overdose is often quite long.After a levothyroxine overdose, the majority of patients are asymptomatic. Symptoms and signs are usually only seen in patients who have taken more than 10 mg of levothyroxine in total.The following are the most commonly seen clinical features in patients developing clinical features:TremorAgitationSweatingInsomniaHeadacheIncreased body temperatureIncreased blood pressureDiarrhoea and vomitingLess common clinical features associated with levothyroxine overdose include:SeizuresAcute psychosisThyroid stormTachycardiaArrhythmiasComaThe continued absorption of the ingested levothyroxine causes a progressive rise in both total serum T4 and total serum T3 levels in the first 24 hours after an overdose. However, in some cases, the biochemical picture is completely normal. Thyroid function tests are not always recommended after a thyroxine overdose. Although elevated thyroxine levels are common, they have little clinical significance and have no impact on treatment. Following a levothyroxine overdose, the following biochemical features are common:T4 and T3 levels in the blood are elevated.Free T4 and Free T3 levels are higher.TSH levels in the blood are low.If the patient is cooperative and more than 10 mg of levothyroxine has been consumed, activated charcoal can be given (i.e., likely to become symptomatic)Within an hour of ingestion, the patient presents.The treatment is mostly supportive and aimed at managing the sympathomimetic symptoms that come with levothyroxine overdose. If beta blockers aren’t an option, try propranolol 10-40 mg PO 6 hours or diltiazem 60-180 mg 8 hours.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      9.3
      Seconds
  • Question 23 - A 66-year-old male was admitted from the Emergency Department due to severe pain...

    Incorrect

    • A 66-year-old male was admitted from the Emergency Department due to severe pain in the left forearm and hand, refractory to pain medication along with pallor and hypothermia of the affected limb. Ultrasound doppler showed an arterial embolism. Circulation was restored after vascular surgery, but there was extensive, irreversible muscle damage. How will the muscle heal from an injury of this type?

      Your Answer: Volkmann’s ischaemic contracture

      Correct Answer: Diffuse formation of fibrous tissue

      Explanation:

      Once muscle tissue is damaged, there will be healing via diffuse formation of fibrous tissue, especially due to the widespread ischemia. Callus formation takes place in the healing of bone, not muscle. Organised scar formation occurs when a lacerated wound is approximated by sutures so that primary intention wound healing can occur. Liquefaction degeneration occurs following ischemia in the brain. Volkmann’s ischemic contracture may occur, but it is not the primary type of healing that will take place but rather the effect of the fibrous scar formation.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      18.1
      Seconds
  • Question 24 - Which of the following muscles is least likely to be involved in forceful expiration:...

    Incorrect

    • Which of the following muscles is least likely to be involved in forceful expiration:

      Your Answer: Transversus abdominis

      Correct Answer: External intercostal muscles

      Explanation:

      Forceful expiration is primarily produced by the deeper thoracic muscles (internal and innermost intercostal muscles, subcostals and transversus thoracis) aided by contraction of the abdominal wall muscles which increase intra-abdominal pressure thus further reducing the volume of the thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      31.5
      Seconds
  • Question 25 - Regarding Clostridium perfringens, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding Clostridium perfringens, which of the following statements is CORRECT:

      Your Answer: It is a facultative anaerobe.

      Correct Answer: It can cause exotoxin-mediated food poisoning.

      Explanation:

      Clostridium perfringens is an obligate anaerobe and has exotoxin mediated effects. It is the most common cause of gas gangrene. C. perfringens is also implicated in food poisoning, cellulitis, enteritis necrotican (life-threatening infection involving ischaemic necrosis of the jejunum), and rarely, CNS infections such as meningitis and encephalitis.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      33.7
      Seconds
  • Question 26 - Which of the following corticosteroids has the most potent mineralocorticoid effect: ...

    Incorrect

    • Which of the following corticosteroids has the most potent mineralocorticoid effect:

      Your Answer: Dexamethasone

      Correct Answer: Fludrocortisone

      Explanation:

      Fludrocortisone has the most potent mineralocorticosteroid activity, making it ideal for mineralocorticoid replacement in adrenal insufficiency.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      46.2
      Seconds
  • Question 27 - A 23-year-old has a known diagnosis of HIV. Blood is sent to the...

    Incorrect

    • A 23-year-old has a known diagnosis of HIV. Blood is sent to the laboratory for tests.AIDS be diagnosed at a CD4 counts below?

      Your Answer: 800 cells/mm 3

      Correct Answer: 200 cells/mm 3

      Explanation:

      A normal CD4 count ranges from 500-1000 cells/mm3.At CD4 count of less than 350 cells/mm3 treatment with anti-retroviral therapy should be considered.At a CD4 count of >200 cells/mm3 AIDS is diagnosed.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      20.7
      Seconds
  • Question 28 - Following the administration of a medication for a heart condition, a 69-year-old man...

    Correct

    • Following the administration of a medication for a heart condition, a 69-year-old man develops hypothyroidism.Which of the following drugs is most likely to be the cause?

      Your Answer: Amiodarone

      Explanation:

      Amiodarone has a chemical structure that is similar to that of thyroxine and can bind to the nuclear thyroid receptor. It can cause both hypothyroidism and hyperthyroidism, though hypothyroidism is far more common, with 5-10% of patients suffering from it.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      57.5
      Seconds
  • Question 29 - A patient suffers an injury to the nerve that innervates gluteus medius.​The gluteus...

    Incorrect

    • A patient suffers an injury to the nerve that innervates gluteus medius.​The gluteus medius muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: Sciatic nerve

      Correct Answer: Superior gluteal nerve

      Explanation:

      Gluteus minimus is innervated by the superior gluteal nerve.Gluteus medius is innervated by the superior gluteal nerve.Gluteus maximus is innervated by the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.2
      Seconds
  • Question 30 - 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
      13
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (4/6) 67%
Upper Limb (3/4) 75%
Microbiology (3/5) 60%
Specific Pathogen Groups (3/4) 75%
Cardiovascular Pharmacology (2/3) 67%
Pharmacology (5/8) 63%
General Pathology (0/2) 0%
Pathology (1/6) 17%
Cardiovascular (1/2) 50%
Physiology (4/7) 57%
Endocrine Physiology (1/1) 100%
CNS Pharmacology (1/1) 100%
Haematology (1/4) 25%
Evidence Based Medicine (0/1) 0%
Study Methodology (0/1) 0%
Basic Cellular (0/1) 0%
Renal Physiology (0/2) 0%
Respiratory (2/2) 100%
Endocrine Pharmacology (1/2) 50%
Thorax (0/1) 0%
Pathogens (0/1) 0%
Endocrine (1/1) 100%
Lower Limb (1/1) 100%
Passmed