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Question 1
Incorrect
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One of your patients is in resuscitation and is suffering from kidney failure. The intensive care outreach team arrives to assess them and determines that a dopamine infusion is necessary.Dopamine primarily acts on which of the following receptors at low doses?
Your Answer: Alpha-1 receptors
Correct Answer: Dopamine receptors
Explanation:Dopamine is a catecholamine that occurs naturally and is used to treat low cardiac output, septic shock, and renal failure. It is both adrenaline and noradrenaline’s immediate precursor.Dopamine acts on D1 and D2 dopamine receptors in the renal, mesenteric, and coronary beds at low doses (1-5 g/kg/min). Dopamine causes a significant decrease in renal vascular resistance and an increase in renal blood flow at these doses. Within this dose range, it is also involved in central modulation of behaviour and movement.Dopamine stimulates beta- and alpha-adrenergic receptors directly and indirectly at higher doses. Beta-stimulation predominates at a rate of 5-10 g/kg/min, resulting in a positive inotropic effect that increases cardiac output and coronary blood flow. Alpha-stimulation predominates at infusion rates greater than 15 g/kg/min, resulting in peripheral vasoconstriction and an increase in venous return and systolic blood pressure.Below is a summary of the mechanisms and effects of various inotropic agents:InotropeMechanismEffectsAdrenaline (epinephrine)Beta-1 and -2 agonist at increasing doses;Alpha-agonist at high dosesIncreased cardiac output;Vasoconstriction at higher dosesNoradrenaline (norepinephrine)Mainly alpha-agonist;Beta-1 and -2 agonist at increasing dosesVasoconstriction;Some increased cardiac outputDopamineDopamine agonist at low doses;Beta-1 and -2 agonist at increasing doses;Alpha-agonist at high dosesIncreased cardiac output;Vasoconstriction at higher dosesDobutamineMainly beta-1 agonistIncreased cardiac output
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 2
Incorrect
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A 22 year old male has been stabbed and is brought to the ED with a stab wound to his upper limb. On examination, the patient is unable to flex the distal interphalangeal joints of the ring and little finger. However, the proximal interphalangeal joint is intact. The most likely affected nerve is which of the following, and at which level is this occurring?
Your Answer: Median nerve in proximal forearm
Correct Answer: Ulnar nerve at elbow
Explanation:The medial half of the flexor digitorum profundus is innervated by the ulnar nerve. Paralysis of this muscle results in loss of flexion at the distal interphalangeal joint of the ring and little finger. Flexion at the proximal interphalangeal joint is preserved as this is a function of the flexor digitorum superficialis which is innervated by the median nerve. The ulnar nerve is not correct as ulnar nerve injury at the wrist would not affect the long flexors, and the injury must have been more proximal.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 3
Incorrect
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Liquefactive necrosis is most commonly seen in which of the following conditions:
Your Answer: Acute pancreatitis
Correct Answer: Ischaemic stroke
Explanation:Liquefactive necrosis results in the loss of all cellular structure and the formation of a soft, semi-solid mass. This is commonly seen in the brain after a cerebral infarction.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 4
Incorrect
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You review a 50-year-old man that is requesting the seasonal influenza vaccination.Which of the following single clinical risk groups is NOT eligible to receive the seasonal influenza vaccination? Select ONE answer only.
Your Answer: All pregnant women
Correct Answer: Patients over the age of 50
Explanation:Patients with hypertension are only eligible for the seasonal influenza vaccination if they have co-existent cardiac complications.The UK national policy is that the seasonal influenza vaccine should be offered to the following groups:All those aged 65 years and olderChildren aged 2 to 15 yearsResidents of nursing and residential homes for the elderly (and other long-stay facilities)Carers of persons whose welfare may be at risk if the carer falls illAll those aged 6 months or older in a clinical risk groupThe following table outlines the clinical risk groups that are considered eligible for the vaccine:CategoryExamples of eligible groupsRespiratory diseaseCOPDInterstitial lung diseaseCystic fibrosisAsthma (requiring oral or inhaled steroids)Heart diseaseCongenital heart diseaseChronic heart failureCoronary heart disease (requiring medication and/or follow-up)Hypertension with cardiac complicationsKidney diseaseChronic kidney diseaseNephrotic syndromeRenal transplant patientsLiver diseaseLiver cirrhosisChronic hepatitisBiliary atresiaNeurological diseaseCerebrovascular accidentTransient ischaemic attackEndocrine diseaseType 1 and 2 diabetesImmunosuppressionPatients undergoing chemotherapyPatients taking immunosuppressive drug therapy (including systemic steroids)Asplenia or splenic dysfunctionHIV infectionPregnancyAll pregnant women
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This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 5
Incorrect
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A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.All the following are responsible for this non-union EXCEPT?
Your Answer: Avascular necrosis
Correct Answer: Osteoporosis
Explanation:An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected. Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 6
Incorrect
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A 67-year-old woman complains of general malaise, nausea, and vomiting. She is perplexed and declares that everything 'looks yellow.' Her potassium level is 6.8 mmol/l, according to a blood test.Which of the drugs listed below is most likely to be the cause of her symptoms?
Your Answer: Lithium
Correct Answer: Digoxin
Explanation:Because digoxin has a narrow therapeutic index, it can cause toxicity both during long-term therapy and after an overdose. Even when the serum digoxin concentration is within the therapeutic range, it can happen.Acute digoxin toxicity usually manifests itself within 2-4 hours of an overdose, with serum levels peaking around 6 hours after ingestion and life-threatening cardiovascular complications following 8-12 hours.Chronic digoxin toxicity is most common in the elderly or those with impaired renal function, and it is often caused by a coexisting illness. The clinical signs and symptoms usually appear gradually over days to weeks.The following are characteristics of digoxin toxicity:Nausea and vomitingDiarrhoeaAbdominal painConfusionTachyarrhythmias or bradyarrhythmiasXanthopsia (yellow-green vision)Hyperkalaemia (early sign of significant toxicity)Some precipitating factors are as follows:Elderly patientsRenal failureMyocardial ischaemiaHypokalaemiaHypomagnesaemiaHypercalcaemiaHypernatraemiaAcidosisHypothyroidismSpironolactoneAmiodaroneQuinidineVerapamilDiltiazem
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 7
Incorrect
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Regarding meningococcal meningitis, which of the following statements is CORRECT:
Your Answer: All healthcare workers should receive chemoprophylaxis if they have come into contact with an infected patient.
Correct Answer: Infection occurs most commonly below the age of 5 years.
Explanation:About half of meningococcal disease occurs in children aged less than five years, and babies are at the highest risk because their immune systems have not yet fully developed. There is a second, smaller increase in risk for older adolescents, mainly for social and behavioural reasons. Infection is most common in winter months. Antibiotics should be given as soon as the diagnosis is suspected (ideally cultures should be performed first but this should not delay treatment), and ceftriaxone/cefuroxime is the first line antibiotic. Only healthcare workers who have been directly exposed to large particle droplets/secretions from the respiratory tract of the index case should receive prophylaxis.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 8
Incorrect
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If the ejection fraction increases, there will be a decrease in:
Your Answer: Stroke volume
Correct Answer: End-systolic volume
Explanation:An increase in ejection fraction means that a higher fraction of the end-diastolic volume is ejected in the stroke volume (e.g. because of the administration of a positive inotropic agent). When this situation occurs, the volume remaining in the ventricle after systole, the end-systolic volume, will be reduced. Cardiac output, stroke volume, and mean arterial pressure will be increased.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 9
Incorrect
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Regarding acute lymphoblastic leukaemia (ALL), which of the following statements is CORRECT:
Your Answer: ALL is characterised by the presence of Reed-Sternberg cells.
Correct Answer: 75% of cases occur before the age of 6 years.
Explanation:Acute lymphoblastic leukaemia (ALL) is caused by an accumulation of lymphoblasts in the bone marrow and is the most common malignancy of childhood. The incidence of ALL is highest at 3 – 7 years, with 75% of cases occurring before the age of 6. 85% of cases are of B-cell lineage. Haematological investigations reveal a normochromic normocytic anaemia with thrombocytopenia in most cases. There is great variation in the chance of individual patients achieving a long-term cure based on a number of biological variables. Approximately 25% of children relapse after first-line therapy and need further treatment but overall 90% of children can expect to be cured. The cure rate in adults drops significantly to less than 5% over the age of 70 years.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 10
Incorrect
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A 40-year-old woman was rushed to the Emergency Department due to an anaphylactic reaction after being stung by a bee. She responded well to initial treatment but developed anaphylactic symptoms after 6 hours. Her symptoms were resolved after a further dose of adrenaline. Her family threatened legal action as they thought she had not received adequate treatment but withdrew their accusation after the attending physician explained that the woman had suffered a biphasic reaction. What is the approximate percentage of people who suffer this type of reaction?
Your Answer: 5%
Correct Answer: 20%
Explanation:Anaphylactic reactions are Type 1 hypersensitivity reactions IgE-mediated and can be potentially life-threatening if not treated promptly. There are four well-recognized patterns of anaphylaxis:1) Uniphasic2) Biphasic3) Protracted4) RefractoryBiphasic reactions occur in 20% of the population, although their mechanism is poorly understood. The symptoms of anaphylaxis recur within 4-6 hours, although they may also recur up to 72 hours later. All patients discharged from the hospital after an anaphylactic shock must:1) Be warned to return to the hospital immediately if symptoms recur2) Have a treatment plan in place3) Have a follow-up appointment4) Be considered for an adrenaline auto-injector5) Referred to an allergy clinic
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 11
Incorrect
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Caseous necrosis is typically seen in which of the following:
Your Answer: Acute pancreatitis
Correct Answer: Tuberculosis
Explanation:Caseous necrosis is most commonly seen in tuberculosis. Histologically, the complete loss of normal tissue architecture is replaced by amorphous, granular and eosinophilic tissue with a variable amount of fat and an appearance reminiscent of cottage cheese.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 12
Incorrect
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The action potential is generated by excitable tissues, which are specialized tissues that can generate a meaningful electrical signal. Local currents transport action potentials down the axons of neurons.Which of the following claims about the action potential's conduction is correct?Â
Your Answer:
Correct Answer: The areas of the membrane that have recently depolarised will not depolarise again due to the refractory period
Explanation:Local currents propagate action potentials down the axons of neurons. Following depolarization, this local current flow depolarizes the next axonal membrane, and when this region crosses the threshold, more action potentials are formed, and so on. Due to the refractory period, portions of the membrane that have recently depolarized will not depolarize again, resulting in the action potential only being able to go in one direction.The square root of axonal diameter determines the velocity of the action potential; the axons with the biggest diameter have the quickest conduction velocities. When a neuron is myelinated, the speed of the action potential rises as well.The myelin sheath is an insulating coating that surrounds certain neural axons. By increasing membrane resistance and decreasing membrane capacitance, the myelin coating increases conduction. This enables faster electrical signal transmission via a neuron, making them more energy-efficient than non-myelinated neuronal axons.Nodes of Ranvier are periodic holes in a myelinate axon when there is no myelin and the axonal membrane is exposed. There are no gated ion channels in the portion of the axon covered by the myelin sheath, but there is a high density of ion channels in the Nodes of Ranvier. Action potentials can only arise at the nodes as a result of this.Electrical impulses are quickly transmitted from one node to the next, causing depolarization of the membrane above the threshold and triggering another action potential, which is then transmitted to the next node. An action potential is rapidly conducted down a neuron in this manner. Saltatory conduction is the term for this.
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This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 13
Incorrect
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Regarding amoxicillin, which of the following statements is INCORRECT:
Your Answer:
Correct Answer: It is used first line for bacterial tonsillitis.
Explanation:Amoxicillin is a derivative of ampicillin and has a similar antibacterial spectrum. It is better absorbed than ampicillin when given orally, producing higher plasma and tissue concentrations; unlike ampicillin, absorption is not affected by the presence of food in the stomach. The adverse effects of amoxicillin are mainly gastrointestinal and mild and include nausea, vomiting and diarrhoea. Amoxicillin is used first line for low to moderate severity community acquired pneumonia, exacerbations of chronic bronchitis, for acute otitis media, for acute sinusitis, for oral infections/dental abscess, for Listeria meningitis (in combination with another antibiotic), for infective endocarditis (in combination with another antibiotic) and for H. Pylori eradication (in combination with metronidazole/clarithromycin and a PPI). Penicillin V is used first line for bacterial tonsillitis; amoxicillin should be avoided in blind treatment of a sore throat as there is a high risk of a rash if glandular fever is present.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 14
Incorrect
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Which of the following is NOT an advantage of a case-control study used to identify past exposure to a risk factor in patients with a disease:
Your Answer:
Correct Answer: Can directly measure absolute and relative risk of a disease
Explanation:Advantages:relatively quickrelatively cheap and easy to performparticularly suitable for studying associations between an exposure and an outcome when the outcome is uncommon or if the outcome occurs decades after exposurea wide range of risk factors can be investigated in each studyDisadvantages:subject to recall biasunlike in a whole population study, absolute risk cannot be quantifiedtemporal relationship between exposure and outcome can be difficult to establishunsuitable for rare risk factorsprone to confounding
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This question is part of the following fields:
- Evidence Based Medicine
- Study Methodology
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Question 15
Incorrect
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Which of the following infections is vancomycin most likely prescribed for?
Your Answer:
Correct Answer: Clostridium difficile colitis
Explanation:125 mg PO q6hr for 10 days is indicated for treatment of Clostridium difficile (C. difficile)-associated diarrhoea
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 16
Incorrect
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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:
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.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 17
Incorrect
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Which of the following statements is not true regarding ion channels?
Your Answer:
Correct Answer: Ion channels provide a charged, hydrophobic pore through which ions can diffuse across the lipid bilayer.
Explanation:Ion channels are pore-forming protein complexes that facilitate the flow of ions across the hydrophobic core of cell membranes. They are present in the plasma membrane and membranes of intracellular organelles of all cells, and perform essential physiological functions. They provide a charged, hydrophilic pore through which ions can move across the lipid bilayer. They are selective for particular ions and their pores may be opened or closed. Because of this ability to open and close, ion channels allow the cell to have the ability to closely control the movement of ions across the membrane. Gating refers to the transition between an open and closed ion channel state, and is brought about by a conformationational change in the protein subunits that open or close the ion-permeable pore. Ion channels can be:1. voltage-gated these are regulated according to the potential difference across the cell membrane or2. ligand-gated – these are regulated by the presence of a specific signal molecule.
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This question is part of the following fields:
- Basic Cellular
- Physiology
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Question 18
Incorrect
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A novel anti-tuberculosis medicine was compared to standard treatment and shown to cut the risk of death from 30 to 10 per 1000 people. How many patients would need to be treated (number need to treat (NNT)) in order to prevent ten additional tuberculosis deaths:
Your Answer:
Correct Answer: 500
Explanation:The risk of mortality in the control group (usual therapy) minus the risk of death in the treatment group equals the absolute risk reduction (ARR) of treatment.30/1000 minus 10/1000 = 20/1000 = 0.02NNT = 1/ARR = 1/0.02 = 50As a result, 50 people would need to be treated in order to prevent one additional fatality, and 500 people would need to be treated in order to avoid 10 additional deaths.
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 19
Incorrect
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Which of the following muscles acts as an extensor of the shoulder joint?
Your Answer:
Correct Answer: Teres major
Explanation:The glenohumeral joint possesses the capability of allowing an extreme range of motion in multiple planes.Flexion – Defined as bringing the upper limb anterior in the sagittal plane. The usual range of motion is 180 degrees. The main flexors of the shoulder are the anterior deltoid, coracobrachialis, and pectoralis major. Biceps brachii also weakly assists in this action.Extension—Defined as bringing the upper limb posterior in a sagittal plane. The normal range of motion is 45 to 60 degrees. The main extensors of the shoulder are the posterior deltoid, latissimus dorsi, and teres major.Internal rotation—Defined as rotation toward the midline along a vertical axis. The normal range of motion is 70 to 90 degrees. The internal rotation muscles are the subscapularis, pectoralis major, latissimus dorsi, teres major, and the anterior aspect of the deltoid.External rotation – Defined as rotation away from the midline along a vertical axis. The normal range of motion is 90 degrees. Primarily infraspinatus and teres minor are responsible for the motion.Adduction – Defined as bringing the upper limb towards the midline in the coronal plane. Pectoralis major, latissimus dorsi, and teres major are the muscles primarily responsible for shoulder adduction.Abduction – Defined as bringing the upper limb away from the midline in the coronal plane. The normal range of motion is 150 degrees. Due to the ability to differentiate several pathologies by the range of motion of the glenohumeral joint in this plane of motion, it is essential to understand how different muscles contribute to this action.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 20
Incorrect
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A 26 year old male presents to emergency room with a 2 day history of burning pain when passing urine, accompanied by a green urethral discharge. Gonorrhoea is suspected. The first line antibiotic for this condition is which of the following?
Your Answer:
Correct Answer: Ceftriaxone
Explanation:When there is a high suspicion of gonorrhoea from clinical features, empiric treatment should be commenced whilst waiting for laboratory confirmation. The first line treatment for uncomplicated anogenital and pharyngeal disease includes ceftriaxone 500 mg IM (single dose) + azithromycin 1 g orally as a single dose. This covers concomitant chlamydia infection. For all people who have been treated for gonorrhoea, a test of cure is recommended
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 21
Incorrect
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Which of the following is NOT an adverse effect of amitriptyline:
Your Answer:
Correct Answer: Hypokalaemia
Explanation:Adverse effects include:Antimuscarinic effects: Dry mouth, Blurred vision, Constipation, Urinary retention, Sedation, ConfusionCardiovascular effects: Heart block, Arrhythmias, Tachycardia, Postural hypotension, QT-interval prolongation, Hepatic impairment, Narrow-angle glaucoma
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 22
Incorrect
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Regarding the lung roots, which of the following statements is CORRECT:
Your Answer:
Correct Answer: Generally the pulmonary arteries lie superior to the pulmonary veins in the lung root.
Explanation:Each lung root contains a pulmonary artery, two pulmonary veins, a main bronchus, bronchial vessels, nerves and lymphatics. Generally the pulmonary artery is superior in the lung root, the pulmonary veins are inferior and the bronchi are somewhat posterior in position. The vagus nerves pass posterior to the lung roots while the phrenic nerves pass anterior to them.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 23
Incorrect
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Urine flow rate = 2 ml/minUrine concentration of creatinine = 18 mg/ml Plasma concentration of creatinine = 0.25 mg/ml What is the estimated glomerular filtration rate (eGFR)?
Your Answer:
Correct Answer: 144 ml/min
Explanation:GFR can be estimated by:GFR = UCr x V / PCrWhere:UCr = urine concentration of creatininePCr = plasma concentration of creatinineV = rate of urine flowIn this case GFR = (18 x 2) / 0.25 = 144 ml/minNote: Creatinine is used to estimate GFR because it is an organic base naturally produced by muscle breakdown, it is freely filtered at the glomerulus, it is not reabsorbed from the nephron, it is not produced by the kidney, it is not toxic, and it doesn’t alter GFR.
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This question is part of the following fields:
- Physiology
- Renal Physiology
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Question 24
Incorrect
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Which of the following laboratory findings is NOT typical of Hodgkin lymphoma:
Your Answer:
Correct Answer: Basophilia
Explanation:Features may include:Normochromic normocytic anaemia is most common; bone marrow failure involvement is unusual in early disease, but if it occurs bone marrow failure may develop with leucoerythroblastic anaemiaOne-third of patients have a neutrophilia; eosinophilia is frequentAdvanced disease is associated with lymphopenia and loss of cell-mediated immunityPlatelet count is normal or increased in early disease and reduced in later stagesESR and CRP are usually raised (ESR is useful in monitoring disease progress)Serum LDH is raised initially in 30-40% of casesDiagnosis is made by histological examination of an excised lymph nodeThe distinctive multinucleate polypoid RS cell is central to the diagnosis of the four classic types of HL (95% of cases)
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This question is part of the following fields:
- Haematology
- Pathology
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Question 25
Incorrect
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Which of the following muscles are primarily involved in passive inspiration:
Your Answer:
Correct Answer: Diaphragm and external intercostal muscles
Explanation:Passive inspiration is produced by contraction of the diaphragm (depressing the diaphragm) and the external intercostal muscles (elevating the ribs). In inspiration, elevation of the sternal ends of the ribs (‘pump handle’ movement), elevation of the lateral shafts of the ribs (‘bucket handle’ movement) and depression of the diaphragm result in expansion of the thorax in an anteroposterior, transverse and vertical direction respectively. This results in an increased intrathoracic volume and decreased intrathoracic pressure and thus air is drawn into the lungs.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 26
Incorrect
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Regarding the cardiac cycle, which of the following statements is INCORRECT:
Your Answer:
Correct Answer: The second heart sound occurs in late diastole caused by closure of the atrioventricular valves.
Explanation:Diastole is usually twice the length of systole at rest, but decreases with increased heart rate. During systole, contraction of the ventricles compresses the coronary arteries and suppresses blood flow. This is particularly evident in the left ventricle, where during systole the ventricular pressure is the same as or greater than that in the arteries and as a result more than 85% of left ventricular perfusion occurs during diastole. This becomes a problem if the heart rate is increased as the diastolic interval is shorter and can result in ischaemia. The second heart sound, caused by closure of the semilunar valves, marks the end of systole.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 27
Incorrect
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Which of the following is NOT a feature characteristic of intravascular haemolysis:
Your Answer:
Correct Answer: Bilirubinuria
Explanation:Features of intravascular haemolysis include:haemoglobinaemia, methaemalbuminaemia, haemoglobinuria (dark urine) and haemosiderinuria
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This question is part of the following fields:
- Haematology
- Pathology
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Question 28
Incorrect
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A 32-year-old woman with a history of bipolar disorder exhibits lithium toxicity symptoms.Which of the following is the MOST LIKELY feature to be present?
Your Answer:
Correct Answer: Clonus
Explanation:Lithium toxicity manifests itself in the following ways:AtaxiaClonusComaConfusionConvulsionsDiarrhoeaIncreased muscle toneNausea and vomitingNephrogenic diabetes insipidusRenal failureTremor
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 29
Incorrect
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Which of the following best describes a natural killer cell:
Your Answer:
Correct Answer: A large granular lymphocyte that kills by inducing target cell apoptosis.
Explanation:Natural killer (NK) cells are cytotoxic CD8 positive cells that lack the T-cell receptor. They are large cells with cytoplasmic granules. NK cells are designed to kill target cells that have a low level of expression of HLA class I molecules, such as may occur during viral infection or on a malignant cell. NK cells do this by displaying several receptors for HLA molecules on their surface. When HLA is expressed on the target cell these deliver an inhibitory signal into the NK cell. When HLA molecules are absent on the target cell this inhibitory signal is lost and the NK cell can then kill its target. In addition, NK cells display antibody-dependent cell-mediated cytotoxicity. In this, antibody binds to antigen on the surface of the target cell and then NK cells bind to the Fc portion of the bound antibody and kill the target cell.
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 30
Incorrect
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Regarding Helicobacter pylori, which of the following statements is INCORRECT:
Your Answer:
Correct Answer: It is found as part of normal colonic flora.
Explanation:Helicobacter pyloriis a Gram-negative, helix shaped (curved rod), microaerophilic bacterium. It typically has 4-6 lophotrichous flagellae and is therefore highly motile. It has an outer membrane consisting of phospholipids and lipopolysaccharide.Helicobacter pyloriIs found in the upper gastrointestinal tract of approximately 50% of the population.Colonization withHelicobacter pyloriconfers a 10-20% lifetime risk of developing peptic ulcers and a 1-2% lifetime risk of developing gastric cancer.There is a strong association between mucosa-associated lymphoid tissue (MALT) lymphoma andHelicobacter pyloricolonization.The most reliable method for testing for colonization withHelicobacter pyloriis by biopsy during endoscopy and histological examination.Typically eradication requires a 14-day course of triple therapy with amoxicillin, clarithromycin and a proton pump inhibitor. Metronidazole is also often used as an alternative antibiotic in a triple therapy regime.Serum antibody levels fall slowly and therefore cannot be used to accurately assess eradication. Either of the 13C-urea breath test or the stool antigen test are viable options for assessing successful eradication.
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This question is part of the following fields:
- Microbiology
- Pathogens
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SESSION STATS - PERFORMANCE PER SPECIALTY
