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Question 1
Incorrect
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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: Anti-dsDNA antibodies are found in around 15% of patients with SLE
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
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 2
Correct
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A patient who has a nerve injury has sparing of the upper half of the orbicularis oculi muscle but not the lower half. Which branch of the facial nerve supplies the lower half of the orbicularis oculi?
Your Answer: Zygomatic branch
Explanation:The facial nerve divides into five terminal branches once in the parotid gland. 1. The temporal branch innervates muscles in the temple, forehead and supraorbital areas.2. The zygomatic branch innervates muscles in the infraorbital area, the lateral nasal area and the upper lip.3. The buccal branch innervates muscles in the cheek, the upper lip and the corner of the mouth. 4. The marginal mandibular branch innervates muscles of the lower lip and chin. 5. The cervical branch innervates the platysma muscle.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 3
Incorrect
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During the second and third trimesters of her pregnancy, a 36-year-old woman is given a drug to treat a medical condition. The foetus has developed hypoperfusion and the oligohydramnios sequence as a result of this.Which of the following drugs is most likely to be the cause of these side effects?
Your Answer: Chloramphenicol
Correct Answer: Ramipril
Explanation:Hypoperfusion, renal failure, and the oligohydramnios sequence are all linked to ACE inhibitor use in the second and third trimesters. The oligohydramnios sequence refers to a foetus’ or neonate’s atypical physical appearance as a result of oligohydramnios in the uterus. It’s also linked to aortic arch obstructive malformations and patent ductus arteriosus.The inhibitory effects on the renin-angiotensin-aldosterone system appear to be the cause of these defects. To avoid these risks, ACE inhibitors should be stopped before the second trimester.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 4
Incorrect
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Which of the following statements is correct regarding the lymphatic system?
Your Answer: The lymphatic system empties into the thoracic duct, which in turn empties into the jugular vein.
Correct Answer: Lymphatic vessels contain both smooth muscle and unidirectional valves.
Explanation:Fluid filtration out of the capillaries is usually slightly greater than fluid absorption into the capillaries. About 8 L of fluid per day is filtered by the microcirculation and returns to the circulation by the lymphatic system. Lymphatic capillaries drain into collecting lymphatics, then into larger lymphatic vessels. Both of these containing smooth muscle and unidirectional valves. From this point, lymph is propelled by smooth muscle constriction and vessel compression by body movements into afferent lymphatics. It then goes to the lymph nodes where phagocytes remove bacteria and foreign materials. It is here that most fluid is reabsorbed by capillaries, and the remainder returns to the subclavian veins via efferent lymphatics and the thoracic duct. The lymphatic system has a major role to play in the body’s immune defence and also has a very important role in the absorption and transportation of fats.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 5
Incorrect
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Regarding inhaled corticosteroids, which of the following statements is INCORRECT:
Your Answer: Side effects include paradoxical bronchospasm.
Correct Answer: Lower doses of inhaled corticosteroids may be required in smokers.
Explanation:Current and previous smoking reduces the effectiveness of inhaled corticosteroids and higher doses may be necessary.
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This question is part of the following fields:
- Pharmacology
- Respiratory
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Question 6
Incorrect
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Regarding renal clearance, which of the following statements is CORRECT:
Your Answer:
Correct Answer: The MDRD equation uses plasma creatinine to estimate the GFR making an adjustment for age, sex and race.
Explanation:Clearance is defined as the volume of plasma that is cleared of a substance per unit time. Inulin clearance is the gold standard for measurement of GFR but creatinine clearance is typically used instead. Creatinine is freely filtered and not reabsorbed, but there is a little creatinine tubular secretion. In practice, GFR is usually estimated from the plasma creatinine using a formula e.g. the MDRD equation making an adjustment for age, sex and race.
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This question is part of the following fields:
- Physiology
- Renal
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Question 7
Incorrect
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A 45-old woman is on several medications and being treated for epilepsy and bipolar disorder. In the ward rounds, you are asked to examine her in detail and discover she has a noticeable tremor. You believe that one of her medications may be responsible for this new onset tremor. Which of the following medications is least likely to be responsible for this tremor?
Your Answer:
Correct Answer: Carbamazepine
Explanation:The only medication that does not commonly cause tremors is carbamazepine.The other drugs present with the following types of tremors as a side effect to their usage:1. Sodium valproate – Postural tremor is most common, but a resting tremor can also occur. Approximately 25% of patients taking sodium valproate are found to develop a tremor within 12 months of starting therapy.2. Lithium – fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer.3. Atypical antipsychotics, such as olanzapine and quetiapine – tremor and limb shakiness.
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 8
Incorrect
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A 33-year-old woman who is investigated for recurrent renal stones is discovered to have a markedly elevated parathyroid hormone (PTH) level.Which of the following would stimulate PTH release under normal circumstances? Select ONE answer only.
Your Answer:
Correct Answer: Decreased plasma calcium concentration
Explanation:Parathyroid hormone (PTH) is a polypeptide containing 84 amino acids. It is the principal controller of free calcium in the body.PTH is synthesised by and released from the chief cells of the four parathyroid glands that are located immediately behind the thyroid gland.PTH is released in response to the following stimuli:Decreased plasma calcium concentrationIncreased plasma phosphate concentration (indirectly by binding to plasma calcium and reducing the calcium concentration)PTH release is inhibited by the following factors:Normal/increased plasma calcium concentrationHypomagnesaemiaThe main actions of PTH are:Increases plasma calcium concentrationDecreases plasma phosphate concentrationIncreases osteoclastic activity (increasing calcium and phosphate resorption from bone)Increases renal tubular reabsorption of calciumDecreases renal phosphate reabsorptionIncreases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol (via stimulation of 1-alpha hydroxylase)Increases calcium and phosphate absorption in the small intestine (indirectly via increased 1,25-dihydroxycholecalciferol)
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This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 9
Incorrect
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A 57-year-old woman receives vitamin B12 injections following a gastrectomy.Which of the following cell types, if absent, is responsible for her vitamin B12 deficiency?
Your Answer:
Correct Answer: Parietal cells
Explanation:Intrinsic factor, produced by the parietal cells of the stomach, is essential for the absorption of vitamin B12 from the terminal ileum. After a gastrectomy, the absorption of vitamin B12 is markedly reduced, and a deficiency will occur.
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This question is part of the following fields:
- Gastrointestinal Physiology
- Physiology
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Question 10
Incorrect
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Regarding skeletal muscle, which of the following best describes the Z-line:
Your Answer:
Correct 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.
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This question is part of the following fields:
- Basic Cellular
- Physiology
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Question 11
Incorrect
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A young man develops an infection spread via aerosol transmission.Which of these organisms is commonly spread by aerosol transmission?
Your Answer:
Correct Answer: Measles virus
Explanation:Aerosols are airborne particles less than 5 µm in size, containing infective organisms that usually cause infection of the upper or lower respiratory tract.Examples of organisms commonly spread by aerosol transmission are:Measles virusVaricella zoster virusMycobacterium tuberculosisThe following table summarises the various routes of transmission with example organisms:Route of transmissionExample organismsAerosol (airborne particle < 5 µm)Mycobacterium tuberculosisVaricella zoster virusMeasles virusHepatitis A and Rotavirus are spread by the faeco-oral route.Neisseria gonorrhoea is spread by sexual route.Staphylococcus aureus is spread by direct contact.
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This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 12
Incorrect
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Regarding Clostridium difficile, which of the following statements is CORRECT:
Your Answer:
Correct Answer: It is normally found in gut flora.
Explanation:C. difficile is normally found in the gut flora but its growth is normally suppressed by more dominant anaerobes. It has exotoxin-mediated effects causing profuse diarrhoea. Oral clindamycin (a broad spectrum antibiotic) is commonly implicated in precipitating C. difficile colitis; first line treatment is with oral metronidazole. Tetanolysin is a toxin produced by Clostridium tetani bacteria.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 13
Incorrect
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Which of the following statement is correct with regards to the female urethra?
Your Answer:
Correct Answer: The urethra opens in the vestibule that lies between the labia minora.
Explanation:The urethra in women is short (about 4 cm long), and begins at the base of the bladder. Its course runs inferiorly through the urogenital diaphragm, then into the perineum. It then opens in the vestibule which lies between the labia minora. The inferior aspect of the urethra is bound to the anterior surface of the vagina. The urethral opening is anterior to the vaginal opening in the vestibule. As the urethra passes through the pelvic floor, it is surrounded by the external urethral sphincter.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 14
Incorrect
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A 38-year-old man returns from an overseas business trip with a fever and a headache. Following investigations a diagnosis of Plasmodium falciparum malaria is made.Which of the following statements regarding Plasmodium falciparum malaria is true? Select ONE answer only.
Your Answer:
Correct Answer: There may be a continuous fever
Explanation:Plasmodium falciparum malaria is transmitted by female of the Anopheles genus of mosquito. The Aedes genus is responsible for transmitting diseases such as dengue fever and yellow fever.Plasmodium falciparumis found globally but is mainly found in sub-Saharan Africa.The incubation period of Plasmodium falciparum malaria is 7-14 days.Sporozoites invade hepatocytes. Within the hepatocyte asexual reproduction occurs producing merozoites, which are released into the blood stream and invade the red blood cells of the host.Artesunate is the drug treatment of choice for Plasmodium falciparum malaria. Quinine can still be used where artesunate is not available. Often combination therapy with drugs such as doxycycline or fansidar is also required.The classic symptom of malaria is the malarial paroxysm, a cyclical occurrence of a cold phase, where the patient experiences intense chills, a hot stage, where the patient feels extremely hot and finally a sweating stage, where the fever declines and the patient sweats profusely. There may also, however, be a continuous fever.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 15
Incorrect
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The term cardiac output refers to the amount of blood pumped by the heart in one minute. The rate in women is around 5 L/min, whereas in men is somewhat higher, around 5.5 L/min.Which of the equations below best describes cardiac output?
Your Answer:
Correct Answer: Stroke volume x heart rate
Explanation:Cardiac output (CO) is calculated by multiplying stroke volume (SV) by heart rate (HR):CO = HR x SVAs a result, both stroke volume and heart rate are exactly proportional to cardiac output. There will be an increase in cardiac output if the stroke volume or heart rate increases, and a reduction in cardiac output if the stroke volume or heart rate lowers.
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This question is part of the following fields:
- Cardiovascular Physiology
- Physiology
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Question 16
Incorrect
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Regarding chronic idiopathic thrombocytopaenic purpura (ITP), which of the following statements is INCORRECT:
Your Answer:
Correct Answer: ITP is classically associated with massive splenomegaly.
Explanation:Chronic ITP is a relatively common disorder. The highest incidence is in women aged 15 – 50 years. It is the most common cause of thrombocytopaenia without anaemia or neutropaenia. It is usually idiopathic but it may been seen in association with other conditions. Platelet autoantibodies (usually IgG) result in the premature removal of platelets from the circulation by macrophages of the reticuloendothelial system. In many causes the antibody is directed against the glycoprotein IIb/IIIa or Ib complex. The normal platelet lifespan of 10 days is reduced to a few hours. Total megakaryocyte mass and platelet turnover are increased to approximately five times normal. Despite the destruction of platelets by splenic macrophages, the spleen is normally not enlarged. In fact, an enlarged spleen should lead to a search for other possible causes for the thrombocytopenia.
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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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A patient with a high potassium level is at risk of going into cardiac arrest. What changes in the ECG may indicate the incident of cardiac arrest in this patient?
Your Answer:
Correct Answer: Peaked T waves and broad QRS complex
Explanation:Severe hyperkalaemia can result in a heart attack or a life-threatening arrhythmia. T waves become narrow-based, pointed, and tall if hyperkalaemia is not treated. The QRS complex widens and eventually merges with the T wave, resulting in a classic sine-wave electrocardiogram. Ventricular fibrillation and asystole are likely to follow.
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This question is part of the following fields:
- Physiology
- Renal
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Question 18
Incorrect
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Regarding Clostridium perfringens, which of the following statements is CORRECT:
Your Answer:
Correct Answer: It can cause exotoxin-mediated food poisoning.
Explanation:Clostridium perfringens is an obligate anaerobe and has exotoxin mediated effects. It is the most common cause of gas gangrene. C. perfringens is also implicated in food poisoning, cellulitis, enteritis necrotican (life-threatening infection involving ischaemic necrosis of the jejunum), and rarely, CNS infections such as meningitis and encephalitis.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 19
Incorrect
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Which of the following clinical features would you least expect to see in a lesion of the frontal lobe:
Your Answer:
Correct Answer: Contralateral homonymous hemianopia with macular sparing
Explanation:Contralateral homonymous hemianopia with macular sparing results from damage to the primary visual cortex of the occipital lobe. Incontinence may occur due to damage of the cortical micturition centre in the prefrontal cortex. Primitive reflexes and inability to problem solve may occur due to damage to the prefrontal cortex. Motor weakness of the contralateral limb with UMN signs may occur due to damage of the primary motor cortex.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 20
Incorrect
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Which of the following clinical features is NOT typical of a facial nerve palsy:
Your Answer:
Correct Answer: Inability to raise the eyelid
Explanation:Facial nerve palsy can result in inability to close the eye due to paralysis of the orbicularis oculi muscle. Elevation of the eyelid in eye opening is a function of the levator palpebrae superioris muscle and the superior tarsal muscle, innervated by the oculomotor nerve and the sympathetic chain respectively.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 21
Incorrect
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Fracture of the medial epicondyle would result to the following, except
Your Answer:
Correct Answer: Weakness of abduction of the thumb
Explanation:Thumb abduction is mediated by the abductor pollicis longus and brevis, which are innervated by the radial and median nerves, respectively.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 22
Incorrect
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You review an 18-months-old child who seems to be having a reaction following an immunisation she took earlier in the day.Which statement concerning immunity and vaccination is true?
Your Answer:
Correct Answer: The strongest immunological response is seen with natural immunity
Explanation:Vaccination induces ACTIVE adaptive immunity. Actively acquired immunity involves the development of an immune response either due to vaccination or natural exposure to a pathogen and leads to long-lasting resistance to infection.Immediate protection is achieved with injection of immunoglobulin. The protection is transient lasting only a few weeks and is useful as post-exposure prophylaxis. Passively acquired immunity usually leads to short-lasting resistance to infection because it does not involve a host immune response. With inactivated bacteria, a series of primary vaccinations is usually required to induce an adequate immune response. In most cases, boosters are required to sustain adequate immunity.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 23
Incorrect
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You've been asked to visit a 20-year-old patient who has been complaining of stomach pain, diarrhoea, and bloating. The GP recently saw the patient and is now looking into numerous possible reasons for stomach hypermotility.Which of the following factors contributes to increased stomach motility?
Your Answer:
Correct Answer: Gastrin
Explanation:Gastrin is a peptide hormone that aids in gastric motility by stimulating the generation of gastric acid by the parietal cells of the stomach. G-cells in the stomach’s pyloric antrum, the duodenum, and the pancreas release it.The following stimuli cause the release of gastrin:Stimulation of the vagus nerveHypercalcaemiastomach bloatingProteins that have been partially digested, particularly amino acids.The presence of acid and somatostatin inhibits the release of gastrin.Gastrin’s main actions are as follows:Gastric parietal cells are stimulated to release hydrochloric acid.ECL cells are stimulated to produce histamine.Gastric parietal cell maturation and fundal growth stimulationCauses the secretion of pepsinogen by the gastric chief cells.Improves antral muscle mobility stimulates gastric contractionsIncreases gastric emptying rate and stimulates pancreatic secretionGallbladder emptying is induced.
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This question is part of the following fields:
- Gastrointestinal Physiology
- Physiology
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Question 24
Incorrect
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A 40-year-old male presents to your clinic complaining of a cough with bloody sputum for the past three months. He has also had fever, night sweats, and has noticed some weight loss over the past three months.Which ONE of the following statements regarding this disease is correct?
Your Answer:
Correct Answer: It can be diagnosed using the Ziehl-Neelson stain
Explanation:Tuberculosis is an infection caused by the microorganism Mycobacterium tuberculosis. TB can affect any organ system in the body, but it most commonly affects the lungs, followed by the lymph nodes. Option Tuberculosis is spread by the faecal-oral route: It is spread by inhalation of droplet nuclei. There are different methods to diagnose a tuberculosis infection. 1) Direct Microscopy: The organisms are visualised using Ziehl-Neelsen or Auramine staining. This is the quickest method to establish a diagnosis and start treatment.2) Culture: M. tuberculosis can be grown on Lowenstein-Jensen or Ogawa mediums, but it can take up to 8 weeks; therefore, ZN staining is also performed to start treatment immediately. Option There are several types of vaccine currently available: The BCG vaccine is the only vaccine approved to prevent TB and is administered at birth. Option Miliary tuberculosis refers to tuberculosis that affects the spine: Miliary tuberculosis refers to a tuberculosis infection disseminated throughout the body’s organ systems via the blood or lymphatics. Pott’s disease is extrapulmonary TB that affects the spine. It usually affects the lower thoracic and upper lumbar regions.Option A Ghon focus typically appears at the apex of a lung: The Ghon focus is a primary sign of TB that forms in the lung of previously unaffected patients. It typically occurs in the mid or lower zones of the lung.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 25
Incorrect
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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.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 26
Incorrect
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The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the postsynaptic cell responds to the neurotransmitter.Which of the following enzymes catalyses the breakdown of noradrenaline?
Your Answer:
Correct Answer: Catechol-O-methyltransferase (COMT)
Explanation:The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the post-synaptic cell responds to the neurotransmitter. This can be accomplished in a variety of ways:Re-uptakeBreakdownDiffusionSerotonin is an example of a neurotransmitter that is uptake. Serotonin is absorbed back into the presynaptic neuron via the serotonin transporter (SERT), which is found in the presynaptic membrane. Re-uptake neurotransmitters are either recycled by repackaging into vesicles or broken down by enzymes.Specific enzymes found in the synaptic cleft can also break down neurotransmitters. The following enzymes are examples of these enzymes:Acetylcholinesterase (AChE) catalyses the acetylcholine breakdown (ACh)The enzyme catechol-O-methyltransferase (COMT) catalyses the breakdown of catecholamines like adrenaline , dopamine and noradrenaline. The breakdown of catecholamines, as well as other monoamines like serotonin, tyramine, and tryptamine, is catalysed by monoamine oxidases (MOA).Diffusion of neurotransmitters into nearby locations can also be used to eliminate them.
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This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 27
Incorrect
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What is the mechanism of action of penicillin antibiotics:
Your Answer:
Correct Answer: Inhibition of bacterial cell wall synthesis
Explanation:Penicillins and the other ß-lactam antibiotics are bactericidal. They produce their antimicrobial action by preventing cross-linkage between the linear peptidoglycan polymer chains that make up the bacterial cell wall. They, therefore, inhibit cell wall synthesis.The integrity of the ß-lactam ring is essential for antimicrobial activity. Many bacteria (including most Staphylococci) are resistant to benzylpenicillin and phenoxymethylpenicillin because they produce enzymes (penicillinases, ß-lactamases) that open the ß-lactam ring.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 28
Incorrect
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Regarding folate requirements, which of the following statements is CORRECT:
Your Answer:
Correct Answer: Dietary folate is found particularly in leafy green vegetables and liver.
Explanation:Megaloblastic anemia results from inhibition of DNA synthesis during red blood cell production. When DNA synthesis is impaired, the cell cycle cannot progress from the growth stage to the mitosis stage. This leads to continuing cell growth without division, which presents as macrocytosis, with an increase in mean corpuscular volume (MCV). The defect in red cell DNA synthesis is most often due to hypovitaminosis, specifically vitamin B12 deficiency or folate deficiency.Folate is an essential vitamin found in most foods, especially liver, green vegetables and yeast. The normal daily diet contains 200 – 250 μg, of which about 50% is absorbed. Daily adult requirements are about 100 μg. Absorption of folate is principally from the duodenum and jejunum. Stores of folate are normally only adequate for 4 months and so features of deficiency may be apparent after this time.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 29
Incorrect
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Tiredness, night sweats, and easy bruising are symptoms of a 58-year-old woman. Splenomegaly is observed during the examination.Which of the following diagnoses is the SINGLE MOST LIKELY?
Your Answer:
Correct Answer: Chronic myeloid leukaemia (CML)
Explanation:CML is a myeloproliferative disorder characterised by an abnormal pluripotent haemopoietic stem cell. A cytogenetic abnormality known as the Philadelphia chromosome, which results from a reciprocal translocation between the long arms of chromosomes 9 and 22, causes more than 80% of cases of CML.CML is a disease that develops slowly over several years. This is known as the ‘chronic stage.’ This stage is usually asymptomatic, and 90 percent of patients are diagnosed at this point, with the disease being discovered frequently as a result of a routine blood test. During this stage, the bone marrow contains less than 10% immature white cells (blasts).When CML cells expand, symptoms typically begin to appear. The ‘accelerated stage’ is what it’s called. Approximately 10% of people are diagnosed at this point. During this stage, between 10% and 30% of blood cells in the bone marrow are blasts. During this stage, common clinical features include:Fatigue and exhaustionNight sweats and feverDistension of the abdomenPain in the left upper quadrant (splenic infarction)Splenomegaly (commonest examination finding)HepatomegalyBruising is simple.Gout is a type of arthritis that affects (rapid cell turnover)Hyperviscosity is a condition in which the viscosity of (CVA, priapism)A small percentage of patients experience a ‘blast crisis’ (blast stage). More than 30% of the blood cells in the bone marrow are immature blast cells at this stage. Patients with severe constitutional symptoms (fever, weight loss, bone pain), infections, and bleeding diathesis typically present at this stage.In CML, laboratory findings include:White cell count is abnormally high (often greater than 100 x 109/l).Increased number of immature leukocytes causes a left shift.Anaemia that is mild to moderately normochromic and normocytic.Platelets can be low, normal, or elevated, and the Philadelphia chromosome can be found in > 80% of patients. Serum uric acid and ALP levels are frequently elevated. Tyrosine kinase inhibitors (TKIs), such as imatinib and dasatinib, are the current mainstay of CML treatment. Allogenic bone marrow transplantation is now only used in cases where TKIs have failed to work.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 30
Incorrect
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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.
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This question is part of the following fields:
- Infections
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
