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  • Question 1 - The muscles of the soft palate (other than the tensor veli palatini) are...

    Incorrect

    • The muscles of the soft palate (other than the tensor veli palatini) are innervated by which of the following nerves:

      Your Answer: Glossopharyngeal nerve

      Correct Answer: Vagus nerve

      Explanation:

      All of the muscles of the soft palate are innervated by the vagus nerve (from the pharyngeal plexus), except for the tensor veli palatini, which is innervated by a branch of the mandibular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      13.8
      Seconds
  • Question 2 - A 27-year-old man was sent to the emergency department by ambulance with suspected...

    Incorrect

    • A 27-year-old man was sent to the emergency department by ambulance with suspected anaphylaxis. What is the best first-line treatment for this patient?

      Your Answer: 0.5 mg of adrenaline intravenously if access has been achieved

      Correct Answer: 500 micrograms of adrenaline intramuscularly

      Explanation:

      Anaphylaxis is the sudden onset of systemic hypersensitivity due to IgE-mediated chemical release from mast cells and basophils. If anaphylaxis is suspected, 500 micrograms of adrenaline should be administered promptly (0.5 ml of 1:1000 solution). In anaphylaxis, the intramuscular route is the most immediate approach; the optimal site is the anterolateral aspect of the middle part of the thigh. Intravenous adrenaline should only be given by people who are well-versed in the use and titration of vasopressors in their routine clinical practice.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      7.8
      Seconds
  • Question 3 - Which of the following is NOT an effect of benzodiazepines: ...

    Incorrect

    • Which of the following is NOT an effect of benzodiazepines:

      Your Answer: Muscle relaxant effect

      Correct Answer: Analgesic effect

      Explanation:

      Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists which enhance inhibitory synaptic transmission throughout the central nervous system, with sedative, hypnotic, anxiolytic, anticonvulsant, amnesic and muscle relaxant properties.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      9.6
      Seconds
  • Question 4 - An injury to which nerve affects innervation to the adductor portion of the...

    Incorrect

    • An injury to which nerve affects innervation to the adductor portion of the adductor magnus?

      Your Answer: Anterior branch of the obturator nerve

      Correct Answer: Posterior branch of the obturator nerve

      Explanation:

      The nerves that supply the adductor magnus muscle have an embryologic origin from the anterior divisions of the lumbosacral plexus and include the obturator nerve, posterior division (L2-4), and the tibial portion of the sciatic nerve (L4). It is innervated by the posterior division of the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      14.5
      Seconds
  • Question 5 - Which of the following is NOT a side effect of phenytoin: ...

    Incorrect

    • Which of the following is NOT a side effect of phenytoin:

      Your Answer: Acne and hirsutism

      Correct Answer: Ototoxicity

      Explanation:

      Adverse effects of phenytoin include:Nausea and vomitingDrowsiness, lethargy, and loss of concentrationHeadache, dizziness, tremor, nystagmus and ataxiaGum enlargement or overgrowthCoarsening of facial features, acne and hirsutismSkin rashesBlood disorders

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      7.7
      Seconds
  • Question 6 - A patient is diagnosed as having a glucagonoma. Her blood serum glucagon concentration...

    Incorrect

    • A patient is diagnosed as having a glucagonoma. Her blood serum glucagon concentration is 1246 pg/mL.Glucagon INHIBITS which of the following processes? Select ONE answer only.

      Your Answer: Lipolysis

      Correct Answer: Glycolysis

      Explanation:

      Glucagon is a peptide hormone that is produced and secreted by alpha cells of the islets of Langerhans, which are located in the endocrine portion of the pancreas. The main physiological role of glucagon is to stimulate hepatic glucose output, thereby leading to increases in glycaemia. It provides the major counter-regulatory mechanism to insulin in maintaining glucose homeostasis.Hypoglycaemia is the principal stimulus for the secretion of glucagon but may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline. Glucagon then causes:GlycogenolysisGluconeogenesisLipolysis in adipose tissueThe secretion of glucagon is also stimulated by:AdrenalineCholecystokininArginineAlanineAcetylcholineThe secretion of glucagon is inhibited by:InsulinSomatostatinIncreased free fatty acidsIncreased urea productionGlycolysis is the metabolic pathway that converts glucose into pyruvate. The free energy released by this process is used to form ATP and NADH. Glycolysis is inhibited by glucagon, and glycolysis and gluconeogenesis are reciprocally regulated so that when one cell pathway is activated, the other is inactive and vice versa.Glucagon has a minor effect of enhancing lipolysis in adipose tissue. Lipolysis is the breakdown of lipids and involves the hydrolysis of triglycerides into glycerol and free fatty acids. It makes fatty acids available for oxidation.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      27.4
      Seconds
  • Question 7 - Which of the following is NOT an advantage of a case-control study used...

    Incorrect

    • 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: Wide range of risk factors can be investigated in each study

      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

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      8.2
      Seconds
  • Question 8 - Which of the following statements accurately describes the flexor digitorum superficialis muscle? ...

    Incorrect

    • Which of the following statements accurately describes the flexor digitorum superficialis muscle?

      Your Answer: It has a point of origin on the lateral epicondyle of the humerus

      Correct Answer: It flexes the middle phalanges of the medial four fingers at the proximal interphalangeal joints

      Explanation:

      Flexor digitorum superficialis is the largest muscle of the anterior compartment of the forearm. It belongs to the superficial flexors of the forearm, together with pronator teres, flexor carpi radialis, flexor carpi ulnaris and palmaris longus. Some sources alternatively classify this muscle as an independent middle/intermediate layer of the anterior forearm, found between the superficial and deep groups.Flexor digitorum superficialis is innervated by muscular branches of the median nerve, derived from roots C8 and T1 that arises from the medial and lateral cords of the brachial plexus. The skin that overlies the muscle is supplied by roots C6-8 and T1.The primary arterial blood supply to the flexor digitorum superficialis is derived from the ulnar artery and its anterior recurrent branch. In addition to branches of the ulnar artery, the anterior and lateral surfaces of the muscle are supplied by branches of the radial artery; and its posterior surface also receives branches from the median artery.The main function of flexor digitorum superficialis is flexion of the digits 2-5 at the proximal interphalangeal and metacarpophalangeal joints. Unlike the flexor digitorum profundus, flexor digitorum superficialis has independent muscle slips for all four digits. This allows it to flex the digits individually at their proximal interphalangeal joints. In addition, flexor digitorum superficialis aids the aids flexion of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      4.8
      Seconds
  • Question 9 - A 70-year-old man has a resting tremor, rigidity, bradykinesia, and a shuffling gait....

    Incorrect

    • A 70-year-old man has a resting tremor, rigidity, bradykinesia, and a shuffling gait. Parkinson's disease is caused by one of the following mechanisms:

      Your Answer: Loss of cholinergic and GABAergic neurons in the caudate nucleus and putamen

      Correct Answer: Loss of dopaminergic neurons in the substantia nigra

      Explanation:

      Parkinson’s disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed but not halted, by treatment. The 2 major neuropathologic findings in Parkinson’s disease are loss of pigmented dopaminergic neurons of the substantia nigra pars compacta and the presence of Lewy bodies and Lewy neurites. See the images below.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      10.6
      Seconds
  • Question 10 - What is the partial pressure of oxygen if it makes up 20.9 percent...

    Correct

    • What is the partial pressure of oxygen if it makes up 20.9 percent of the ambient air composition and the atmospheric pressure of ambient air is 760 mmHg?

      Your Answer: 159 mmHg

      Explanation:

      Ambient air is atmospheric air in its natural state. Ambient air is typically 78.6% nitrogen and 20.9% oxygen. The extra 1% is made up of carbon, helium, methane, argon and hydrogen. The partial pressure of any gas can be calculated using this formula: P = atmospheric pressure (760 mmHg) x percent content in the mixture. Atmospheric pressure is the sum of all of the partial pressures of the atmospheric gases added together: The formula for atmospheric pressure is: Patm = PN2 + PO2 + PH2O + PCO2. The atmospheric pressure is known to be 760 mmHg. The partial pressures of the various gases can be estimated to have partial pressures of approximately 597.4 mmHg for nitrogen, 158.8 mm Hg for oxygen, and 7.6 mmHg for argon.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      5.3
      Seconds
  • Question 11 - A 42-year-old patient with worsening epigastric pain has been referred to you by...

    Incorrect

    • A 42-year-old patient with worsening epigastric pain has been referred to you by a GP. The patient has been taking omeprazole for a month, but her symptoms are getting worse.Which of the following is NOT a well-known side effect of proton pump inhibitor treatment?

      Your Answer: Focal tachyarrhythmias

      Correct Answer: Pelvic fracture

      Explanation:

      Proton pump inhibitors (PPIs) have a variety of side effects, including:Vomiting and nauseaPain in the abdomenFlatulenceDiarrhoeaConstipationHeadachePPIs have been linked to a significant increase in the risk of focal tachyarrhythmias (link is external).Low serum magnesium and sodium levels have been linked to long-term use of PPIs, according to the US Food and Drug Administration (link is external).Long-term PPI use has also been linked to an increased risk of fracture, according to epidemiological evidence (link is external). Observational studies have discovered a slight link between hip, wrist, and spine fractures. However, there is no link between the two and an increased risk of pelvic fracture. For this reason, the MHRA recommends that patients at risk of osteoporosis who take PPIs maintain an adequate calcium and vitamin D intake.

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      19.1
      Seconds
  • Question 12 - A patient is diagnosed with a Klebsiella infection.Which SINGLE statement regarding Klebsiella infections...

    Correct

    • A patient is diagnosed with a Klebsiella infection.Which SINGLE statement regarding Klebsiella infections is true?

      Your Answer: Klebsiella spp are an important cause of ventilator-associated pneumonia

      Explanation:

      Klebsiellais a genus of non-motile,Gram-negative, rod-shaped bacteriawith a prominent polysaccharide-based capsule. They are routinely found in the nose, mouth and gastrointestinal tract as normal flora, however, they can also behave as opportunistic pathogens.Infections with Klebsiella spp. areusually nosocomial. They are an important cause of ventilator-associated pneumonia (VAP), urinary tract infection, wound infection and bacteraemia. Outbreaks of infections with Klebsiellaspp. in high-dependency units have been described and are associated with septicaemia and high mortality rates. Length of hospital stay and performance of invasive procedures are risk factors forKlebsiellainfections.Primary pneumonia withKlebsiella pneumoniaeis a rare,severe, community-acquired infection associated with a poor outcome.Klebsiella rhinoscleromatis causes a progressive granulomatous infection of the nasal passages and surrounding mucous membranes. This infection is mainly seen in the tropics.Klebsiella ozanae is a recognised cause of chronic bronchiectasis.Klebsiella organisms are resistant to multiple antibiotics including penicillins. This is thought to be a plasmid-mediated property. Agents with high intrinsic activity againstKlebsiellapneumoniaeshould be selected for severely ill patients. Examples of such agents include third-generation cephalosporins (e.g cefotaxime), carbapenems (e.g. imipenem), aminoglycosides (e.g. gentamicin), and quinolones (e.g. ciprofloxacin). These agents may be used as monotherapy or combination therapy. Aztreonam may be used in patients who are allergic to beta-lactam antibiotics.Species with ESBLs (Extended spectrum beta-lactamase) are resistant to penicillins and also cephalosporins such as cefotaxime and ceftriaxone.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      21.9
      Seconds
  • Question 13 - Regarding skeletal muscle, which of the following best describes the Z-line: ...

    Correct

    • Regarding skeletal muscle, which of the following best describes the Z-line:

      Your Answer: A line dividing muscle fibres into sarcomeres

      Explanation:

      Each muscle fibre is divided at regular intervals along its length into sarcomeres separated by Z-lines. The sarcomere is the functional unit of the muscle.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      12.8
      Seconds
  • Question 14 - Which of the following statements is correct regarding anti-D immunoglobulin? ...

    Incorrect

    • Which of the following statements is correct regarding anti-D immunoglobulin?

      Your Answer: It is only administered after sensitising events in rhesus-negative mothers.

      Correct Answer: It is administered as part of routine antenatal care for rhesus-negative mothers.

      Explanation:

      In all non-sensitised pregnant women who are RhD-negative, it is recommended that routine antenatal anti-D prophylaxis is offered. Even if there is previous anti-D prophylaxis, use of routine antenatal anti-D prophylaxis should be given for a sensitising event early in the same pregnancy. Postpartum anti-D prophylaxis should also be given even if there has been previous routine antenatal anti-D prophylaxis or antenatal anti-D prophylaxis for a sensitising event in the same pregnancy.

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      12.4
      Seconds
  • Question 15 - At rest, the left dome of the diaphragm normally reaches as high as...

    Incorrect

    • At rest, the left dome of the diaphragm normally reaches as high as which of the following:

      Your Answer: Sixth intercostal space

      Correct Answer: Fifth intercostal space

      Explanation:

      At rest the right dome of the diaphragm lies slightly higher than the left; this is thought to be due to the position of the liver. In normal expiration, the normal upper limits of the superior margins are the fifth rib for the right dome, the fifth intercostal space for the left dome and the xiphoid process for the central tendon.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      31.7
      Seconds
  • Question 16 - Which of the following factors does NOT decrease glucagon secretion: ...

    Incorrect

    • Which of the following factors does NOT decrease glucagon secretion:

      Your Answer: Somatostatin

      Correct Answer: Catecholamines

      Explanation:

      Factors that increase glucagon secretion:↓ Blood glucose↑ Amino acidsCholecystokininCatecholaminesAcetylcholineFactors that decrease glucagon secretion:↑ Blood glucoseInsulinSomatostatinFatty acids, ketoacids

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      9.6
      Seconds
  • Question 17 - A 15-year-old boy was brought to the emergency room with complaints of a...

    Incorrect

    • A 15-year-old boy was brought to the emergency room with complaints of a headache, stiffness of the neck, and photophobia. Upon observation, the following were noted: HR 124, BP 86/43, RR 30, SaO 95%, temperature 39.5 deg C. A recently developed non-blanching rash on his legs was also observed.What is most likely the causative agent of the case presented above?

      Your Answer: Neisseria meningitidis group A

      Correct Answer: Neisseria meningitidis group B

      Explanation:

      The meningococcus is solely a human pathogen, and up to 50% of the population may carry meningococci in the nasopharynx. Factors that lead to invasion and production of disease include complex inter-relationships of genetic predisposition, host status, environmental conditions, and virulence of the organism.Meningococcal disease is the most common infectious cause of death in childhood in developed countries. It presents as septicaemia, meningitis, or a combination. Septicaemia is the more dangerous presentation, especially with septic shock; meningitis is more likely to lead to neurodevelopmental sequelae. Classic features of septicaemia are a non-blanching rash in a feverish, ill child.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      50.8
      Seconds
  • Question 18 - In the emergency room, a 28-year-old woman complains of wobbly and slurred speech,...

    Correct

    • In the emergency room, a 28-year-old woman complains of wobbly and slurred speech, is unable to do the heel-shin test, and has nystagmus. The following signs are most likely related to damage to which of the following areas:

      Your Answer: Cerebellum

      Explanation:

      Cerebellar injury causes delayed and disorganized motions. When walking, people with cerebellar abnormalities sway and stagger. Damage to the cerebellum can cause asynergia, the inability to judge distance and when to stop, dysmetria, the inability to perform rapid alternating movements or adiadochokinesia, movement tremors, staggering, wide-based walking or ataxic gait, a proclivity to fall, weak muscles or hypotonia, slurred speech or ataxic dysarthria, and abnormal eye movements or nystagmus.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      10.5
      Seconds
  • Question 19 - All of the statements regarding vascular tone are correct except: ...

    Incorrect

    • All of the statements regarding vascular tone are correct except:

      Your Answer: L-type Ca 2+ channel blockers are clinically effective vasodilators.

      Correct Answer: Most endogenous vasodilators act by decreasing levels of cAMP or cGMP.

      Explanation:

      Most vasoconstrictors bind to G-protein coupled receptors. These mediate elevation in intracellular [Ca2+] which leads to vascular smooth muscle contraction. Important vasoconstrictors include noradrenaline, endothelin-1 and angiotensin II. Increased intracellular Ca2+ is as a result of the release of Ca2+from the sarcoplasmic reticulum and depolarisation and entry of Ca2+via L-type voltage-gated Ca2+channels. Most types of vascular smooth muscle do not generate action potentials – instead, the depolarisation is graded, which allows graded entry of Ca2+.sequestration by the sarcoplasmic reticulum Ca2+ATPase, removal from the cell by a plasma membrane Ca2+ATPase and Na+/Ca2+exchange decreases intracellular Ca2+, resulting in vasodilation. Relaxation is a result of most endogenous vasodilators when there is an increase in cyclic guanosine monophosphate (cGMP) like nitric oxide) or cyclic adenosine monophosphate (cAMP) like prostacyclin and beta-adrenergic receptor agonists. These activate protein kinases causing substrate level phosphorylation. Clinically effective vasodilators are L-type Ca2+channel blocker drugs.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      41
      Seconds
  • Question 20 - Which of the following drugs used in the management of hyperkalaemia does not...

    Incorrect

    • Which of the following drugs used in the management of hyperkalaemia does not affect serum potassium levels:

      Your Answer: Salbutamol

      Correct Answer: Calcium gluconate

      Explanation:

      Calcium gluconate is given to antagonise cardiac cell membrane excitability to reduce the risk of arrhythmias. It has no effect on serum potassium levels unlike the alternative drugs listed above.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      16.4
      Seconds
  • Question 21 - Carbon dioxide is transported in the blood approximately: ...

    Incorrect

    • Carbon dioxide is transported in the blood approximately:

      Your Answer: 80% as bicarbonate ions, 15% as carbamino compounds and 5% 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
      7.1
      Seconds
  • Question 22 - Molecules with a molecular weight of less than which of the following are...

    Incorrect

    • Molecules with a molecular weight of less than which of the following are filtered freely at the glomerular filtration barrier:

      Your Answer: 10000 Da

      Correct Answer: 7000 Da

      Explanation:

      Molecular weight is the main factor in determining whether a substance is filtered or not – molecules < 7 kDa in molecular weight are filtered freely e.g. glucose, amino acids, urea, ions but larger molecules are increasingly restricted up to 70 kDa, above which filtration is insignificant. Negatively charged molecules are further restricted, as they are repelled by negative charges, particularly in the basement membrane. Albumin has a molecular weight of 69 kDa and is negatively charged, thus only very small amounts are filtered (and all of the filtered albumin is reabsorbed in the proximal tubule), whereas small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. This means that ultrafiltrate is virtually protein free, but otherwise has an identical composition of that of plasma. The epithelial lining of the Bowman's capsule consists of a single layer of cells called podocytes. The glomerular capillary endothelium is perforated by pores (fenestrations) which allow plasma components with a molecular weight of < 70 kDa to pass freely.

    • This question is part of the following fields:

      • Physiology
      • Renal
      3.4
      Seconds
  • Question 23 - Adenosine is primarily indicated for which of the following: ...

    Incorrect

    • Adenosine is primarily indicated for which of the following:

      Your Answer: Ventricular tachycardia

      Correct Answer: Paroxysmal supraventricular tachycardia

      Explanation:

      Adenosine is usually the treatment of choice for terminating paroxysmal supraventricular tachycardia including those associated with accessory conduction pathways e.g. Wolff-Parkinson-White syndrome.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      9.6
      Seconds
  • Question 24 - A 26-year-old female cuts her hand on a knife while preparing dinner but...

    Correct

    • A 26-year-old female cuts her hand on a knife while preparing dinner but the bleeding stops within a few minutes. Which one of the following cells will be among the first to be present at the wound site to be involved in haemostasis?

      Your Answer: Platelets

      Explanation:

      Platelets are the first cells to be attracted to the wound site due to the release of the Von Willebrand factor from the damaged endothelium. Platelets, in turn, release cytokines such as platelet-derived growth factor, which will attract other inflammatory cells to the wound site.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      13.4
      Seconds
  • Question 25 - Which of the following immunoglobulins is most important for mast cell degranulation: ...

    Incorrect

    • Which of the following immunoglobulins is most important for mast cell degranulation:

      Your Answer: IgA

      Correct Answer: IgE

      Explanation:

      IgA is the major Ig in secretions, particularly from the gastrointestinal tract (but also in saliva, tears, sweat and breast milk).IgE is important for mast cell degranulation in allergic and antiparasitic response. In the allergic response, the plasma cell produces IgE-antibodies, which, like antibodies of other immunoglobulin isotypes, are capable of binding a specific allergen via its Fab portion.IgG is the most abundant in plasma (comprising 80% of normal serum immunoglobulin) and the main circulatory Ig for the secondary immune response.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      6.7
      Seconds
  • Question 26 - A 75-year-old man with rheumatoid arthritis had gained weight, developed resistant hypertension, muscle...

    Incorrect

    • A 75-year-old man with rheumatoid arthritis had gained weight, developed resistant hypertension, muscle weakness, and ankle oedema. This patient is most likely suffering from what condition?

      Your Answer: Cushing's disease

      Correct Answer: Cushing's syndrome

      Explanation:

      Overuse of cortisol medication, as seen in the treatment of patients with chronic asthma or rheumatoid arthritis, can cause Cushing’s syndrome. Weight gain, thin arms and legs, a round face, increased fat around the base of the neck, a fatty hump between the shoulders, easy bruising, wide purple stretch marks primarily on the abdomen, breasts, hips, and under the arms, weak muscles, hirsutism, hypertension, erectile dysfunction, osteoporosis, frontal alopecia, acne, depression, poor wound healing, and polycythaemia are all clinical features of Cushing’s syndrome.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      11.4
      Seconds
  • Question 27 - A 66-year-old female with a history of stroke one year ago presents to...

    Incorrect

    • A 66-year-old female with a history of stroke one year ago presents to the Family Medicine clinic complaining of fatigue, weight loss, and tongue discolouration. On examination, she seems malnourished, her tongue is beefy red, and an ataxic gait pattern is noticed. Which ONE of the following conditions does this patient most likely have?

      Your Answer:

      Correct Answer: Vitamin B12 deficiency

      Explanation:

      A history of stroke and poor nutritional status points towards a nutritional deficiency as the most likely cause of her symptoms. The examination would differentiate between Vitamin B12 and Folic acid deficiency as in the former. The patient has a beefy red tongue and symptoms indicating peripheral nervous system involvement or subacute combined spinal cord degeneration. The patient may also have a lemon-yellow skin colour, loss of proprioception and vibratory sense and oral ulceration. Investigations in B12 deficiency can reveal the following:1. Macrocytic anaemia2. Neutropoenia3. Thrombocytopaenia4. Blood film: anisocytosis, poikilocytosis5. Low serum B126. Raised serum bilirubin (haemolysis)7. Intrinsic factor antibodies8. Positive Schilling test

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 28 - Streptococcus pneumoniae is commonly implicated in all of the following infectious diseases EXCEPT...

    Incorrect

    • Streptococcus pneumoniae is commonly implicated in all of the following infectious diseases EXCEPT for:

      Your Answer:

      Correct Answer: Impetigo

      Explanation:

      Impetigo is a highly contagious infection of the superficial epidermis that most commonly affects young children but can occur in any age group. In children it is the most common bacterial skin infection and it is the third most common skin disease overall, behind dermatitis and viral warts.The commonest causative organism is Staphylococcus aureus. Streptococcus pyogenesis the second commonest and causes fewer cases, either alone or in combination withS. aureus.The streptococcal form tends to be commoner in warmer, more humid climates. (Hirschmann JV. Impetigo: etiology and therapy. Curr Clin Top Infect Dis. 2002;22:42–51.)Impetigo is most commonly spread by direct person-to-person contact, and can spread rapidly through families and school classes. It can also, less commonly, be spread by indirect contact.There are two main forms of impetigo:Non-bullous impetigo – lesions usually start as tiny pustules or vesicles that evolve rapidly into honey-crusted plaques that tend to be under 2 cm in diameter. These can be itchy but are rarely painful.Bullous impetigo – lesions have a thin roof and tend to rupture spontaneously. This type is more likely to be painful and may be associated with systemic upset.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 29 - Which of the following clinical features is most suggestive of a lesion of...

    Incorrect

    • Which of the following clinical features is most suggestive of a lesion of the occipital lobe:

      Your Answer:

      Correct Answer: Homonymous hemianopia

      Explanation:

      Homonymous hemianopia is a visual field defect involving either the two right or the two left halves of the visual fields of both eyes. It is caused by lesions of the retrochiasmal visual pathways, ie, lesions of the optic tract, the lateral geniculate nucleus, the optic radiations, and the cerebral visual (occipital) cortex

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 30 - Which of the following statements about sickle cell disease is TRUE: ...

    Incorrect

    • Which of the following statements about sickle cell disease is TRUE:

      Your Answer:

      Correct Answer: Hand-foot syndrome is frequently a first presentation of the disease.

      Explanation:

      Hand-foot syndrome in children is typically the first symptom of the disease, produced by infarction of the metaphysis of small bones. The disease is inherited as an autosomal recessive trait. By adulthood, the spleen has usually infarcted. Infection with the B19 parvovirus is usually followed by an aplastic crisis. Thrombocytopenia is caused by splenic sequestration.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (1/6) 17%
Head And Neck (0/1) 0%
Pharmacology (0/7) 0%
Respiratory (0/2) 0%
Anaesthesia (0/1) 0%
Lower Limb (0/1) 0%
Central Nervous System (1/3) 33%
Endocrine Physiology (0/1) 0%
Physiology (2/8) 25%
Evidence Based Medicine (0/1) 0%
Study Methodology (0/1) 0%
Upper Limb (0/1) 0%
Respiratory Physiology (1/1) 100%
Gastrointestinal Pharmacology (0/1) 0%
Microbiology (1/2) 50%
Specific Pathogen Groups (1/2) 50%
Basic Cellular (1/1) 100%
Immunoglobulins And Vaccines (0/1) 0%
Thorax (0/1) 0%
Endocrine (0/2) 0%
Cardiovascular (0/2) 0%
Fluids And Electrolytes (0/1) 0%
Renal (0/1) 0%
General Pathology (1/1) 100%
Pathology (1/2) 50%
Immune Responses (0/1) 0%
Passmed