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  • Question 1 - Cryptococcus neoformans is primarily implicated in which of the following conditions: ...

    Correct

    • Cryptococcus neoformans is primarily implicated in which of the following conditions:

      Your Answer: Chronic lymphocytic meningitis

      Explanation:

      Cryptococcus neoformans typically causes a chronic lymphocytic meningitis in immunosuppressed patients or those with intense exposure e.g. pigeon fanciers.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      41.6
      Seconds

  • Question 2 - A newborn baby is born by vaginal delivery to a mother who has...

    Correct

    • A newborn baby is born by vaginal delivery to a mother who has a Chlamydia infection and who is started on treatment after the delivery. The neonate subsequently develops an infection also.Which one of these is the most common neonatal manifestation of Chlamydia trachomatis infection?

      Your Answer: Conjunctivitis

      Explanation:

      Conjunctivitis is the most common neonatal manifestation of Chlamydia trachomatis infection. The second commonest neonatal manifestation is pneumoniaOphthalmia neonatorum refers to any conjunctivitis in the newborn period, irrespective of causative organism. Presently, chlamydia is the single most common cause, accounting for up to 40% of cases. Ophthalmia neonatorum caused by chlamydia typically presents 5 to 14 days after birth with unilateral or bilateral watery discharge that progressively becomes more copious and purulent. There is no associated risk of ulceration and perforation, and the eyes are less inflamed.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      28.6
      Seconds

  • Question 3 - A 33 year old lady with a known nut allergy was having dinner...

    Correct

    • A 33 year old lady with a known nut allergy was having dinner at a Thai restaurant. She suddenly complained of lip and tongue swelling and difficulty breathing and is brought to ED by ambulance with suspected anaphylaxis. She received intramuscular adrenaline in the ambulance.The most appropriate doses of the second line treatments for anaphylaxis are which of the following?

      Your Answer: 10 mg chlorphenamine and 200 mg hydrocortisone

      Explanation:

      Second line drugs to reduce the severity and duration of anaphylactic symptoms are intravenous or intramuscular chlorpheniramine and hydrocortisone. The recommended dose is 10 mg chlorpheniramine and 200 mg hydrocortisone in adults.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      76.8
      Seconds

  • Question 4 - Which of the following statements is incorrect regarding the Na+/K+ATPase pump? ...

    Incorrect

    • Which of the following statements is incorrect regarding the Na+/K+ATPase pump?

      Your Answer: The Na + /K + ATPase pump moves ions against their concentration gradients.

      Correct Answer: The Na + /K + ATPase pump moves 3 Na + ions into the cell for every 2 K + ions out.

      Explanation:

      In order for primary active transport to pump ions against their electrochemical gradient, chemical energy is used in the form of ATP. The Na+/K+-ATPase antiporter pump uses metabolic energy to move 3 Na+ions out of the cell for every 2 K+ions in, against their respective electrochemical gradients. As a result, the cell the maintains a high intracellular concentration of K+ions and a low concentration of Na+ions.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      43.5
      Seconds

  • Question 5 - Following a phone call from the microbiology consultant, you evaluate a patient who...

    Incorrect

    • Following a phone call from the microbiology consultant, you evaluate a patient who has been diagnosed with urinary sepsis. Following the results of the blood cultures, he recommends that you add gentamicin to the patient's antibiotic treatment.Gentamicin produces its pharmacological effect by binding to which of the following? 

      Your Answer: DNA gyrase

      Correct Answer: The 30S subunit of the bacterial ribosome

      Explanation:

      Antibiotics with aminoglycosides, such as gentamicin, bind to the 30S subunit of the bacterial ribosome and prevent aminoacyl-tRNA from binding, preventing protein synthesis.They also cause mRNA misreading, resulting in the production of non-functional proteins. This last mechanism is unique to aminoglycosides, and it may explain why they are bactericidal rather than bacteriostatic, as other protein synthesis inhibitors are.Patients with myasthenia gravis should avoid aminoglycosides since they can disrupt neuromuscular transmission. They cross the placenta and are linked to poisoning of the 8th cranial nerve in the foetus, as well as permanent bilateral deafness.It is possible that they will cause deafness, although this is not a contraindication. In individuals with renal impairment, serum aminoglycoside concentrations should be closely monitored, but this is still not considered a contraindication.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      64.4
      Seconds

  • Question 6 - All of the following are indications for beta-blockers EXCEPT for: ...

    Incorrect

    • All of the following are indications for beta-blockers EXCEPT for:

      Your Answer: Anxiety

      Correct Answer: Raynaud's disease

      Explanation:

      Beta-blockers are contraindicated in Raynaud’s syndrome. Beta-blockers may be indicated in:HypertensionPheochromocytoma (only with an alpha-blocker)AnginaSecondary prevention after ACSArrhythmias including atrial fibrillationHeart failureThyrotoxicosisAnxietyProphylaxis of migraineEssential tremorGlaucoma

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      16.3
      Seconds

  • Question 7 - In the Paediatric Emergency Department, you saw a 6-year-old girl with severe bilateral conjunctivitis....

    Incorrect

    • In the Paediatric Emergency Department, you saw a 6-year-old girl with severe bilateral conjunctivitis. You give her mother some general eye hygiene advice and prescribe chloramphenicol eye drops.What is the chloramphenicol's mechanism of action?

      Your Answer:

      Correct Answer: Inhibition of protein synthesis

      Explanation:

      Chloramphenicol is a broad-spectrum antibiotic that inhibits bacterial protein synthesis by blocking the 50S subunit of the bacterial ribosome’s peptidyl transferase activity. When administered systemically, it has limited usage due to the potential of significant side effects such as aplastic anaemia, peripheral neuropathy, and optic neuritis. It’s only used to treat typhoid fever and Haemophilus influenzae meningitis, but it’s usually better to use a broad-spectrum cephalosporin.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 8 - A critically ill 48-year-old individual appears with symptoms and signs of an anaphylactic...

    Incorrect

    • A critically ill 48-year-old individual appears with symptoms and signs of an anaphylactic reaction.In an allergic reaction, which of the following is an absolute contraindication to the injection of adrenaline?

      Your Answer:

      Correct Answer: None of the other options

      Explanation:

      Even if the following relevant contraindications exist, adrenaline can be given in life-threatening anaphylactic reactions:Coronary artery disease (CAD) Coronary artery disease (CAD)  Second stage of labourHypertension that is uncontrolledSevere Ventricular arrhythmias

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds

  • Question 9 - A 40-year-old woman presents with a fever and headache upon returning from an...

    Incorrect

    • A 40-year-old woman presents with a fever and headache upon returning from an overseas business trip. Upon further investigation, a diagnosis of Plasmodium falciparum malaria was made.All of the following statements is considered true regarding Plasmodium falciparum malaria, except:

      Your Answer:

      Correct Answer: It is commonly the result of travel in the Indian subcontinent

      Explanation:

      The mean incubation period for P. falciparum is 12 days.WHO World Malaria Report 2019 states that an estimated 228 million cases of malaria occurred worldwide in 2018, and reports steadily decreasing the number of cases since 2010. In 2018, nineteen sub-Saharan African countries and India carried approximately 85% of the global malaria burden. The most prevalent and pathogenic malaria parasite, most commonly associated with severe illness and death, especially in the WHO African region, accounting for 99.7% malaria cases, is P. falciparum.The vector for Plasmodium spp. is a female Anopheles mosquito that inoculates sporozoites contained in her salivary glands into the puncture wound when feeding. Sporozoites enter peripheral bloodstream and are uptake by hepatocytes, where they undergo an asexual pre-erythrocytic liver-stage as liver schizonts lasting up to 2 weeks before the onset of the blood stage.Intravenous or intramuscular artesunate is the first-line treatment in all patients worldwide and should be used for at least 24 hours and until the oral medication is tolerated.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 10 - Co-amoxiclav is used first line for which of the following indications: ...

    Incorrect

    • Co-amoxiclav is used first line for which of the following indications:

      Your Answer:

      Correct Answer: Animal bite

      Explanation:

      Co-amoxiclav is used first line for infected and prophylaxis of infection in animal and human bites.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 11 - A 65-year-old man complains of severe vertigo, nausea, and tinnitus. Upon presenting himself...

    Incorrect

    • A 65-year-old man complains of severe vertigo, nausea, and tinnitus. Upon presenting himself to the emergency room, it was observed that he is exhibiting ataxia, right-sided loss of pain and temperature sense on the face, and left-sided sensory loss to the body. An MRI and CT scan was ordered and the results showed that he is suffering from a right-sided stroke. Branches of which of the following arteries are most likely implicated in the case?

      Your Answer:

      Correct Answer: Basilar artery

      Explanation:

      The lateral pontine syndrome occurs due to occlusion of perforating branches of the basilar and anterior inferior cerebellar (AICA) arteries. It is also known as Marie-Foix syndrome or Marie-Foix-Alajouanine syndrome. It is considered one of the brainstem stroke syndromes of the lateral aspect of the pons.It is characterized by ipsilateral limb ataxia, loss of pain and temperature sensation of the face, facial weakness, hearing loss, vertigo and nystagmus, hemiplegia/hemiparesis, and loss of pain and temperature sensation.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 12 - You suspected a fungal nail infection in a 50-year-old man who presented with...

    Incorrect

    • You suspected a fungal nail infection in a 50-year-old man who presented with an itchy, scaly rash between his toes and a thicker, discoloured nail on his big toe that has been there for almost one month already. Which of the following tests is most likely to confirm your suspected diagnosis?

      Your Answer:

      Correct Answer: Nail clippings for microscopy and culture

      Explanation:

      Nail clippings for microscopy and culture are a diagnostic test for fungal infection. Because some fungi are restricted to the lower parts of the nail, clippings should be taken from the discoloured or brittle parts and cut back as far as possible from the free edge.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 13 - Regarding carbohydrate, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

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

      Explanation:

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

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds

  • Question 14 - Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that...

    Incorrect

    • Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus.Which ONE of these statements about ANAs is true?

      Your Answer:

      Correct Answer: They can be of any immunoglobulin class

      Explanation:

      Anti-nuclear antibodies(ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus. They can be of any immunoglobulin class.CREST syndrome is usually associated with anti-centromere antibodies.ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most reliable.Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.Anti-dsDNA antibodies are found in 80 – 90% of patients with SLE

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds

  • Question 15 - A 24-year-old student with red and painful right eye presents. Conjunctival erythema, mucopurulent...

    Incorrect

    • A 24-year-old student with red and painful right eye presents. Conjunctival erythema, mucopurulent discharge and lid crusting are seen on examination, and patient denies presence of itching of the eye. All his observations are normal, he has no fever and is otherwise well.Which of these is the most likely causative organism?

      Your Answer:

      Correct Answer: Haemophilus influenzae

      Explanation:

      The most frequent cause of red eye is conjunctivitis. It is caused by inflammation of the conjunctiva which can be infective or allergic and accounts for about 35% of all eye problems presenting to general practice.Viral conjunctivitis is commonly caused by adenoviruses and it is the most common infectious conjunctivitis.The common bacterial causes of conjunctivitis are Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.The clinical features of infective conjunctivitis include:Acute onset of conjunctival erythemaFeeling ‘grittiness’, ‘foreign body’ or ‘burning’ sensation in the eye.Watering and discharge which may cause transient blurring of visionThe discharge for viral conjunctivitis is less than that of bacterial conjunctivitis and usually watery.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 16 - Which of the following is NOT a mineralocorticoid effect of corticosteroids: ...

    Incorrect

    • Which of the following is NOT a mineralocorticoid effect of corticosteroids:

      Your Answer:

      Correct Answer: Hyperglycaemia

      Explanation:

      Mineralocorticoid side effects include:hypertensionsodium retentionwater retention and oedemapotassium losscalcium lossGlucocorticoid side effects include:weight gainhyperglycaemia and diabetesosteoporosis and osteoporotic fracturesmuscle wasting (proximal myopathy)peptic ulceration and perforationpsychiatric reactions

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      0
      Seconds

  • Question 17 - An analytical study is conducted to compare the risk of stroke between Ticagrelor...

    Incorrect

    • An analytical study is conducted to compare the risk of stroke between Ticagrelor therapy and Warfarin therapy among patients with atrial fibrillation. The following is obtained from the study:No. of patients who took Ticagrelor: 300No. of patients who took Ticagrelor and suffered a stroke: 30No. of patients who took Warfarin: 500No. of patients who took Warfarin and suffered a stroke: 20Compute for the absolute risk reduction of a stroke, with Warfarin as the standard of treatment.

      Your Answer:

      Correct Answer: -0.06

      Explanation:

      Absolute risk reduction (ARR) is computed as the difference between the absolute risk in the control group (ARC) and the absolute risk in the treatment group (ART).Since Warfarin is the standard of treatment, Warfarin is considered as the control group.ARR = ARC-ARTARR = (20/500) – (30/300)ARR = -0.06This means that there is increased risk of stroke in the treatment group, which is the Ticagrelor group.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds

  • Question 18 - 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:

      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
      0
      Seconds

  • Question 19 - Which of the following ions normally has the highest concentration in intracellular fluid: ...

    Incorrect

    • 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%).

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 20 - A patient in the Emergency Department had a diagnosis of diabetic ketoacidosis (DKA)...

    Incorrect

    • A patient in the Emergency Department had a diagnosis of diabetic ketoacidosis (DKA) and you commence an insulin infusion. Which of these statements concerning insulin is true?

      Your Answer:

      Correct Answer: Insulin has a short half-life of around 5-10 minutes

      Explanation:

      Insulin, a peptide hormone, is produced in the pancreas by the beta-cells of the islets of Langerhans.The beta-cells first synthesise an inactive precursor called preproinsulin which is converted to proinsulin by signal peptidases, which remove a signal peptide from the N-terminus. Proinsulin is converted to insulin by the removal of the C-peptide.Insulin has a short half-life in the circulation of about 5-10 minutes.Glucagon and parasympathetic stimulation stimulates insulin release.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds

  • Question 21 - External haemorrhoids may cause anal pain. When explaining to your patient why it...

    Incorrect

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

      Your Answer:

      Correct Answer: Pudendal nerve

      Explanation:

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 22 - Which of the following best describes the process of opsonisation: ...

    Incorrect

    • Which of the following best describes the process of opsonisation:

      Your Answer:

      Correct Answer: The coating of foreign particles with molecules which allow easier recognition of that cell by phagocytes

      Explanation:

      An opsonin is any molecule that enhances phagocytosis by marking an antigen for an immune response, for example, immunoglobulin or complement. Opsonisation is the molecular mechanism whereby molecules, microbes, or apoptotic cells are chemically modified to have a stronger attraction to the cell surface receptors on phagocytes and natural killer cells. With the antigen coated in opsonins, binding to immune cells is greatly enhanced. Opsonisation also mediates phagocytosis via signal cascades from cell surface receptors.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds

  • Question 23 - A 22 year old professional athlete sustains an inversion injury to her left...

    Incorrect

    • A 22 year old professional athlete sustains an inversion injury to her left ankle during the 800m. Which of the following ligaments is most likely injured:

      Your Answer:

      Correct Answer: Anterior talofibular ligament

      Explanation:

      Inversion injuries at the ankle in plantarflexion (such as when wearing high heels) are common, and typically result in damage to the lateral collateral ligament of the ankle, made up of the anterior talofibular, the calcaneofibular and the posterior talofibular ligaments. The anterior talofibular and the calcaneofibular ligaments are most commonly injured, and the posterior talofibular ligament rarely. The spring ligament supports the head of the talus, the deltoid ligament supports the medial aspect of the ankle joint, and the long and short plantar ligaments are involved in maintaining the lateral longitudinal arch of the foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 24 - You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble...

    Incorrect

    • You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble breathing after eating peanuts. Which of the following diagnostic tests will confirm this?

      Your Answer:

      Correct Answer: Mast cell tryptase

      Explanation:

      The concentration of serum tryptase rises in anaphylaxis and anaphylactoid responses. Because tryptase is a significant component of mast cell granules, mast cell degranulation causes elevated tryptase levels in the blood. Although tryptase levels are not always high during anaphylaxis, it is considered a particular marker.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      0
      Seconds

  • Question 25 - How does dipyridamole mediate its antiplatelet effect: ...

    Incorrect

    • How does dipyridamole mediate its antiplatelet effect:

      Your Answer:

      Correct Answer: It is a phosphodiesterase inhibitor.

      Explanation:

      Dipyridamole inhibits both the reuptake of adenosine and phosphodiesterase, preventing the degradation of cAMP and thus blocking the platelet aggregation response to ADP.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 26 - Which of these increases osteoclast activity? ...

    Incorrect

    • Which of these increases osteoclast activity?

      Your Answer:

      Correct Answer: Parathyroid hormone

      Explanation:

      Osteoclasts are bone cell that break down bone tissue. Parathyroid hormone increases osteoclastic activity.1,25-dihydroxycholecalciferol increases osteoclastic activityCalcitonin inhibits osteoclastic activityBisphosphonates are osteoclast inhibitors.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds

  • Question 27 - Which of the following is NOT a notifiable disease: ...

    Incorrect

    • Which of the following is NOT a notifiable disease:

      Your Answer:

      Correct Answer: HIV

      Explanation:

      HIV mainly infects CD4+ T helper cells. Viral replication results in progressive T-cell depletion and impaired cell-mediated immunity with subsequent secondary opportunistic infections and increased risk of malignancy. B-cell function is also reduced as a result of lack of T-cell stimulation.HIV is not a notifiable disease.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 28 - A 34-year-old man presents with loss of vision in his left eye due...

    Incorrect

    • A 34-year-old man presents with loss of vision in his left eye due to an episode of optic neuritis. Upon history taking, it was noted that he has a history of multiple sclerosis. Which of the following anatomical points in the visual pathway has the lesion occurred?

      Your Answer:

      Correct Answer: Optic nerve

      Explanation:

      A lesion in the optic nerve causes ipsilateral monocular visual loss.Optic neuritis is an inflammatory demyelination of the optic nerve that is highly associated with multiple sclerosis. The two most common symptoms of optic neuritis are vision loss and eye pain.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 29 - Which of the following is NOT a typical side effect of digoxin: ...

    Incorrect

    • Which of the following is NOT a typical side effect of digoxin:

      Your Answer:

      Correct Answer: Hypokalaemia

      Explanation:

      Digoxin does not cause hypokalaemia, but hypokalaemia does potentiate digoxin toxicity. The adverse effects of digoxin are frequently due to its narrow therapeutic window and include: Cardiac adverse effects – Sinoatrial and atrioventricular block, Premature ventricular contractions, PR prolongation and ST-segment depressionNausea, vomiting and diarrhoeaBlurred or yellow visionCNS effects – weakness, dizziness, confusion, apathy, malaise, headache, depression, psychosisThrombocytopenia and agranulocytosis (rare)Gynaecomastia in men in prolonged administration

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 30 - Glomerular filtration rate can be calculated using any substance that: ...

    Incorrect

    • Glomerular filtration rate can be calculated using any substance that:

      Your Answer:

      Correct Answer: is freely filtered and neither reabsorbed nor secreted by the nephron

      Explanation:

      Clearance of a substance can provide an accurate estimate of the glomerular filtration rate (GFR) provided that the substance is:freely filterednot reabsorbed in the nephronnot secreted in the nephronnot synthesised or metabolised by the kidney

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (2/2) 100%
Pathogens (1/1) 100%
Specific Pathogen Groups (1/1) 100%
Pharmacology (1/3) 33%
Respiratory (1/1) 100%
Basic Cellular (0/1) 0%
Physiology (0/1) 0%
Infections (0/1) 0%
Cardiovascular (0/1) 0%
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