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  • Question 1 - You review a patient with a history of Addison’s disease. He takes 100...

    Correct

    • You review a patient with a history of Addison’s disease. He takes 100 mg of hydrocortisone per day to control this.What dose of prednisolone is equivalent to this dose of hydrocortisone? Select ONE answer only.

      Your Answer: 25 mg

      Explanation:

      Prednisolone is four times more potent than hydrocortisone, and therefore, a dose of 25 mg would be equivalent to 100 mg of hydrocortisone.The following table summarises the relative potency of the main corticosteroids compared with hydrocortisone:CorticosteroidPotency relative to hydrocortisonePrednisolone4 times more potentTriamcinolone5 times more potentMethylprednisolone5 times more potentDexamethasone25 times more potent

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      35.7
      Seconds
  • Question 2 - A 35 year old patient presents to ED having sustained an injury to...

    Correct

    • A 35 year old patient presents to ED having sustained an injury to his right hand whilst playing cricket. He is unable to fully straighten his right middle finger as the distal phalanx remains flexed. Which of the following structures within the digit was most likely injured:

      Your Answer: Insertion of terminal extensor digitorum tendon

      Explanation:

      Damage to the insertion of the terminal extensor digitorum tendon would result in loss of extension at the distal interphalangeal joint causing a fixed flexion deformity, called the Mallet deformity.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      94
      Seconds
  • Question 3 - Which of the following clinical features is NOT a typical feature of haemolytic...

    Incorrect

    • Which of the following clinical features is NOT a typical feature of haemolytic anaemias:

      Your Answer: Leg ulcers

      Correct Answer: Angular cheilitis

      Explanation:

      Features include: AnaemiaJaundice (caused by unconjugated bilirubin in plasma, bilirubin is absent from urine)Pigment gallstonesSplenomegalyAnkle ulcersExpansion of marrow with, in children, bone expansion e.g. frontal bossing in beta-thalassaemia majorAplastic crisis caused by parvovirus

    • This question is part of the following fields:

      • Haematology
      • Pathology
      29.1
      Seconds
  • Question 4 - A 32 year old man is brought to ED having been thrown off...

    Correct

    • A 32 year old man is brought to ED having been thrown off his motorbike. Following initial resuscitation and ruling out life-threatening injuries, you establish the patient has weakness of hip flexion. Which of the following nerves has most likely been injured:

      Your Answer: Femoral nerve

      Explanation:

      Flexion of the hip is produced by the iliacus, the psoas major, the sartorius, rectus femoris and the pectineus muscles. The femoral nerve innervates the iliacus, pectineus, sartorius and quadriceps femoris muscles, and supplies skin on the anterior thigh, anteromedial knee and medial leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      74.5
      Seconds
  • Question 5 - Which of these cell types in the stomach releases pepsinogen? ...

    Correct

    • Which of these cell types in the stomach releases pepsinogen?

      Your Answer: Chief cells

      Explanation:

      The gastric chief cells in the stomach wall releases pepsinogen. Pepsinogen is a proenzyme. It mixes with hydrochloric acid in the stomach and is converted to pepsin. Pepsin breaks down proteins into peptides aiding protein digestion.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      5.3
      Seconds
  • Question 6 - A 75-year-old man with rheumatoid arthritis had gained weight, developed resistant hypertension, muscle...

    Correct

    • 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 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
      59.9
      Seconds
  • Question 7 - Which of the following is first-line for management of status epilepticus: ...

    Correct

    • Which of the following is first-line for management of status epilepticus:

      Your Answer: Intravenous lorazepam

      Explanation:

      First-line treatment is with intravenous lorazepam if available. Intravenous diazepam is effective but it carries a high risk of thrombophlebitis so should only be used if intravenous lorazepam is not immediately available. Absorption of diazepam from intramuscular injection or from suppositories is too slow for treatment of status epilepticus. When facilities for resuscitation are not immediately available or if unable to secure immediate intravenous access, diazepam can be administered as a rectal solution or midazolam oromucosal solution can be given into the buccal cavity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      13.4
      Seconds
  • Question 8 - A 40-year-old woman presents with a fever and headache upon returning from an...

    Correct

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

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

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      23.1
      Seconds
  • Question 9 - Haemophilia B results from a deficiency in: ...

    Incorrect

    • Haemophilia B results from a deficiency in:

      Your Answer: Factor X

      Correct Answer: Factor IX

      Explanation:

      Haemophilia B is a bleeding disorder caused by a deficiency of clotting factor IX. It is the second commonest form of haemophilia, and is rarer than haemophilia A. Haemophilia B tends to be similar to haemophilia A but less severe. The two disorders can only be distinguished by specific coagulation factor assays.The incidence is one-fifth of that of haemophilia A. Laboratory findings demonstrate prolonged APTT, normal PT and low factor IX.Haemophilia B inherited in an X-linked recessive fashion, affecting males born to carrier mothers.There is also a variation called Leyden, in which factor IX levels are below 1% until puberty, when they rise, potentially reaching as high as 40-60% of normal. This is thought to be due to the effects of testosterone at puberty.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      21.8
      Seconds
  • Question 10 - An 8-year-old boy was brought to the emergency room with complaints of a...

    Incorrect

    • An 8-year-old boy was brought to the emergency room with complaints of a rash and fever that have been present for the past 3 days. Upon history taking and observation, it was noted that the rash started behind the ears and then spread to the face and body. The presence of coryzal symptoms, dry cough, and conjunctivitis was also observed.What is most likely the diagnosis of the case presented above?

      Your Answer: Typhoid

      Correct Answer: Measles

      Explanation:

      The measles virus is an enveloped virus classified in the genusMorbillivirus.Measles is highly contagious and spreads by aerosol. Initial replication takes place in the mucosal cells of the respiratory tract; measles virus then replicates in the local lymph nodes and spreads systemically. The virus circulates in the T and B cells and monocytes, until eventually the lungs, gut, bile duct, bladder, skin, and lymphatic organs are involved. After an incubation period of 7 to 10 days, there is an abrupt onset, with symptoms of sneezing, runny nose and cough, red eyes, and rapidly rising fever. About 2 to 3 days later, a maculopapular rash appears on the head and trunk. Koplik spots, lesions on the oral mucosa consisting of irregular red spots, with a bluish white speck in the centre, generally appear 2 to 3 days before the rash and are diagnostic.Measles is easily diagnosed clinically, so few requests for laboratory identification are made. The virus is fragile and must be handled carefully. The specimens of choice are from the nasopharynx and urine, but the virus can only be recovered from these sources in the early stages of infection. The virus grows on PMK cells, causing the formation of distinctive spindle-shaped or multinucleated cells.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      6
      Seconds
  • Question 11 - C5 - C9 deficiency increases susceptibility to infection with which of the following:...

    Incorrect

    • C5 - C9 deficiency increases susceptibility to infection with which of the following:

      Your Answer: Intracellular bacteria

      Correct Answer: Neisseria spp.

      Explanation:

      If the complement sequence is completed, an active phospholipase (the membrane attack complex, MAC) is produced, which punches holes in the cell membrane and causes cell lysis. Because the MAC appears to be the sole means to destroy the Neisseria family of bacteria, C5 – C9 deficiency increases susceptibility to Neisseria infections.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      146.1
      Seconds
  • Question 12 - At rest, saliva is produced predominantly by which of the following: ...

    Incorrect

    • At rest, saliva is produced predominantly by which of the following:

      Your Answer: Von Ebner's glands

      Correct Answer: Submandibular gland

      Explanation:

      At rest, most saliva is produced by the submandibular gland (65%). When stimulated by the autonomic nervous system, about 50% of saliva is produced by the parotid gland with only 30% produced by the submandibular gland.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      25.5
      Seconds
  • Question 13 - Due to severe palpitations, a 28-year-old woman is transported to the Emergency Department...

    Incorrect

    • Due to severe palpitations, a 28-year-old woman is transported to the Emergency Department by ambulance. Her heart rate is 180 beats per minute, and the rhythm strip shows supraventricular tachycardia. You intend to give adenosine.Which of the following is NOT a contraindication for adenosine use?

      Your Answer: 2 nd -degree heart block

      Correct Answer: History of heart transplant

      Explanation:

      The purine nucleoside adenosine is used to diagnose and treat paroxysmal supraventricular tachycardia. Adenosine works by stimulating A1-adenosine receptors and opening potassium channels that are sensitive to acetylcholine. This causes the atrioventricular (AV) node’s cell membrane to become hyperpolarized, slowing conduction by inhibiting calcium channels.Patients who have had a heart transplant are extremely sensitive to the effects of adenosine and should start with a lower dose of 3 mg, then 6 mg, and finally 12 mg. Dipyridamole potentiates the effects of adenosine, so it should be used with caution in patients who are taking it.The use of adenosine is contraindicated in the following situations:AsthmaCOPD (chronic obstructive pulmonary disease)Decompensated heart failure Long QT syndromeAV block in the second or third degreeSinusitis is a condition in which the sinuses become (unless pacemaker fitted)Hypotension that is severeIt has a half-life of less than 10 seconds and acts quickly within that time frame. The actions last between 10 and 20 seconds. Because of the short half-life of the drug, any side effects are usually only temporary. These are some of them:a feeling of impending doomFlushing of the faceDyspnoeaUncomfortable chestTastes metallic

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      26.1
      Seconds
  • Question 14 - Which of the following statements is true regarding the extensor pollicis longus? ...

    Incorrect

    • Which of the following statements is true regarding the extensor pollicis longus?

      Your Answer: It extends the thumb at the carpometacarpal joint

      Correct Answer: It is innervated by the posterior interosseous nerve

      Explanation:

      Extensor pollicis longus is part of the deep extensors of the forearm together with extensor pollicis brevis, abductor pollicis longus, extensor indicis and supinator muscles. It is located on the posterior aspect of forearm, extending from the middle third of the ulna, and adjacent interosseous membrane, to the distal phalanx of the thumb.Extensor digitorum is innervated by posterior interosseous nerve which is a continuation of a deep branch of radial nerve (root value C7 and C8).Extensor pollicis brevis receives its blood supply from the posterior interosseous artery and perforating branches of the anterior interosseous artery.The main action of extensor pollicis longus is extension of the thumb at the metacarpophalangeal and interphalangeal joints. Extension at the metacarpophalangeal joint occurs in synergy with extensor pollicis brevis muscle. When the thumb reaches the full extension or abduction, extensor pollicis longus can also assist in adduction of the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      21.9
      Seconds
  • Question 15 - Regarding the UK routine childhood immunisation schedule which of the following vaccines is...

    Incorrect

    • Regarding the UK routine childhood immunisation schedule which of the following vaccines is NOT given at 12 months:

      Your Answer: Measles, mumps and rubella (MMR)

      Correct Answer: Polio

      Explanation:

      At 12 months the following vaccines are given:Hib (4th dose) and Meningococcal group CPneumococcal (13 serotypes) (2nd dose)Measles, mumps and rubellaMeningococcal group B (3rd dose)

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      34.8
      Seconds
  • Question 16 - A 66-year-old male presents to his family physician with the complaint of increasing...

    Incorrect

    • A 66-year-old male presents to his family physician with the complaint of increasing fatigue and lethargy, along with itching, especially after a hot bath. He also complains of increased sweating and dizziness. On examination, he has a plethoric appearance. Abdominal examination shows the presence of splenomegaly. A basic panel of blood tests is ordered in which her Hb comes out to be 17 g/dL. Which one of the following treatment options will be most suitable in this case?

      Your Answer: Erythropoietin

      Correct Answer: Venesection

      Explanation:

      The clinical and laboratory findings, in this case, support a diagnosis of polycythaemia vera. A plethoric appearance, lethargy, splenomegaly and itching are common in this disease. Patients may also have gouty arthritis, Budd-Chiari syndrome, erythromelalgia, stroke, myocardial infarction or DVT. The average age for diagnosis of Polycythaemia Vera is 65-74 years. It is a haematological malignancy in which there is overproduction of all three cell lines. Venesection is the treatment of choice as it would cause a decrease in the number of red blood cells within the body.Erythropoietin is given in patients with chronic renal failure as they lack this hormone. Administration of erythropoietin in such patients causes stimulation of the bone marrow to produce red blood cells. Desferrioxamine is a chelating agent for iron and is given to patients with iron overload due to repeated blood transfusions, e.g. in thalassemia patients.Penicillamine is a chelating agent for Copper, given as treatment in Wilson’s disease.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      9
      Seconds
  • Question 17 - A 25-year-old athlete suffers an injury to the nerve that innervates the gluteus...

    Correct

    • A 25-year-old athlete suffers an injury to the nerve that innervates the gluteus minimus muscle.Which of the following nerves innervates the gluteus minimus muscle?

      Your Answer: Superior gluteal nerve

      Explanation:

      Gluteus minimus is the smallest muscle of the glutei. It is located just beneath the gluteus medius muscle. Gluteus minimus predominantly acts as a hip stabilizer and abductor of the hip. The superior gluteal nerve innervates the gluteus minimus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      53
      Seconds
  • Question 18 - A 25-year-old man suffers from a shoulder injury that damaged the nerve that...

    Incorrect

    • A 25-year-old man suffers from a shoulder injury that damaged the nerve that innervates the infraspinatus muscle.Which of the following nerves may most likely be affected?

      Your Answer: The axillary nerve

      Correct Answer: The suprascapular nerve

      Explanation:

      The suprascapular nerve (C5-C6) innervates the infraspinatus. It originates at the superior trunk of the brachial plexus. It runs laterally across the lateral cervical region to supply the infraspinatus and also the supraspinatus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      130.7
      Seconds
  • Question 19 - An 80-year-old woman with history of hypertension, diabetes, and ischemic stroke, presents with...

    Incorrect

    • An 80-year-old woman with history of hypertension, diabetes, and ischemic stroke, presents with left-sided hemiplegia of the face, tongue, and limbs and right-sided deficits in motor eye activity. A CT scan was ordered and showed a right-sided stroke. Branches of which of the following arteries are most likely implicated in the case?

      Your Answer: Vertebral artery

      Correct Answer: Basilar artery

      Explanation:

      Weber syndrome is a midbrain stroke characterized by crossed hemiplegia along with oculomotor nerve deficits and it occurs with the occlusion of the median and/or paramedian perforating branches of the basilar artery. Typical clinical findings include ipsilateral CN III palsy, ptosis, and mydriasis (such as damage to parasympathetic fibres of CN III) with contralateral hemiplegia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      40.1
      Seconds
  • Question 20 - A 39-year-old man with a long history of depression presents after intentionally overdoing...

    Incorrect

    • A 39-year-old man with a long history of depression presents after intentionally overdoing his heart medication. Verapamil immediate-release 240 mg is the tablet he takes for this condition, he says. He took the pills about 30 minutes ago, but his wife discovered him right away and rushed him to the emergency room.At the moment, he is completely symptom-free. When it comes to this type of overdose, how long does it usually take for symptoms to appear?

      Your Answer: 3-6 hours

      Correct Answer: 1-2 hours

      Explanation:

      Overdosing on calcium-channel blockers should always be taken seriously and regarded as potentially fatal. Verapamil and diltiazem are the two most lethal calcium channel blockers in overdose. These work by binding the alpha-1 subunit of L-type calcium channels, preventing calcium from entering the cell. In cardiac myocytes, vascular smooth muscle cells, and islet beta-cells, these channels play an important role.>10 tablets of verapamil (160 mg or 240 mg immediate or sustained-release capsules) or diltiazem can cause serious toxicity (180 mg, 240 mg or 360 mg immediate or sustained-release capsules)In children, 1-2 tablets of verapamil or diltiazem (immediate or sustained-release)Symptoms usually appear within 1-2 hours of ingestion with standard preparations. However, with slow-release preparations, significant toxicity may take 12-16 hours to manifest, with peak effects occurring after 24 hours.The following are the main clinical features of calcium-channel blocker overdose:Nausea and vomitingHypotensionBradycardia and first-degree heart blockMyocardial ischaemia and strokeRenal failurePulmonary oedemaHyperglycaemiaThe following are some of the most important bedside investigations to conduct:Blood glucoseECGArterial blood gasOther investigations that can be helpful includeUrea & electrolytesChest X-ray (pulmonary oedema)Echocardiography

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      13.7
      Seconds
  • Question 21 - A 33-year-old female, who recently returned from a trip to Bangladesh, presents to...

    Incorrect

    • A 33-year-old female, who recently returned from a trip to Bangladesh, presents to the infectious diseases clinic with complaints of productive cough with blood-stained sputum, night sweats, and weight loss for the past one month. Based on the history and examination findings, you suspect pulmonary tuberculosis. Which ONE of the following investigations is most appropriate to make a diagnosis of active tuberculosis?

      Your Answer: Blood culture

      Correct Answer: Sputum for acid-fast bacilli smear

      Explanation:

      Multiple investigations may be done to establish a diagnosis of active tuberculosis. In this case, sputum for acid-fast bacilli would be the best option as it can be done immediately, give fast results, and promptly initiate treatment. Three-morning sputum samples are collected and tested for acid-fast bacilli using gram staining. Blood culture would yield results in tuberculous bacteraemia and would be less sensitive than sputum testing. A chest X-ray would not differentiate active tuberculosis from an old infection in which the Ghon complex has formed, and the body’s immune reaction contains the Mycobacterium tuberculosis bacteria. Mantoux test shows the presence of antibodies to tuberculosis and may be positive if the patient has had a previous infection or been vaccinated against tuberculosis. A CT chest would also be unable to differentiate between an active infection and the findings of old tuberculosis infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      5.1
      Seconds
  • Question 22 - Cardiac myocytes are connected to each other by which of the following: ...

    Incorrect

    • Cardiac myocytes are connected to each other by which of the following:

      Your Answer: Microglia

      Correct Answer: Intercalated discs

      Explanation:

      Adjacent cardiac myocytes are connected to each other by intercalated discs. The intercalated discs provide both a structural attachment by ‘glueing’ cells together at desmosomes and an electrical contact made up of proteins called connexons, called a gap junction, which essentially creates a low-resistance pathway between cells.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      14.5
      Seconds
  • Question 23 - You examine an elderly man who is experiencing chest pain. He doesn't recall...

    Incorrect

    • You examine an elderly man who is experiencing chest pain. He doesn't recall all of his medications, but he does know that he takes a diuretic.The enzyme carbonic anhydrase is inhibited by which of the following diuretics?

      Your Answer: Furosemide

      Correct Answer: Acetazolamide

      Explanation:

      Acetazolamide is a non-competitive, reversible inhibitor of carbonic anhydrase found in the cytosol of cells and on the brush border of the proximal convoluted tubule. Bicarbonate and hydrogen ions are converted to carbonic acid by carbonic anhydrase, which then converts carbonic acid to carbon dioxide and water. As a result, acetazolamide reduces the availability of hydrogen ions, causing sodium and bicarbonate ions to accumulate in the renal tubule, resulting in diuresis.The mechanism of action of the various types of diuretics is summarised below:1) Loop diuretics, e.g. furosemide, bumetanideAct on the Na.K.2Cl co-transporters in the ascending loop of Henlé to inhibit sodium, chloride and potassium reabsorption.2) Thiazide diuretics, e.g. Bendroflumethiazide, hydrochlorothiazideAct on the Na.Cl co-transporter in the distal convoluted tubule to inhibit sodium and chloride reabsorption.3) Osmotic diuretics, e.g. mannitolIncreases the osmolality of the glomerular filtrate and tubular fluid, increasing urinary volume by an osmotic effect.4) Aldosterone antagonists, e.g. spironolactoneActs in the distal convoluted tubule as a competitive aldosterone antagonist resulting in inhibition of sodium reabsorption and increasing potassium reabsorption.5) Carbonic anhydrase inhibitors, e.g. acetazolamideInhibit the enzyme carbonic anhydrase preventing the conversion of bicarbonate and hydrogen ions into carbonic acid.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      262.2
      Seconds
  • Question 24 - Regarding bicarbonate handling by the proximal tubule, which of the following statements is...

    Incorrect

    • Regarding bicarbonate handling by the proximal tubule, which of the following statements is CORRECT:

      Your Answer: HCO 3 - passes across the basolateral membrane of the tubular cell largely by simple diffusion.

      Correct Answer: For each H + secreted into the lumen, one Na + and one HCO 3 - is reabsorbed into the plasma.

      Explanation:

      About 80% of bicarbonate is reabsorbed in the proximal tubule. HCO3-is not transported directly, tubular HCO3-associates with H+secreted by epithelial Na+/H+antiporters to form carbonic acid (H2CO3) which readily dissociates to form carbon dioxide and water in the presence of carbonic anhydrase. CO2and water diffuse into the tubular cells, where they recombine to form carbonic acid which dissociates to H+and HCO3-. This HCO3-is transported into the interstitium largely by Na+/HCO3-symporters on the basolateral membrane (and H+is secreted back into the lumen). For each H+secreted into the lumen, one Na+and one HCO3-are reabsorbed into the plasma. H+is recycled so there is little net secretion of H+at this stage.

    • This question is part of the following fields:

      • Physiology
      • Renal
      27.5
      Seconds
  • Question 25 - Which of the following is an example of a non-parametric test: ...

    Incorrect

    • Which of the following is an example of a non-parametric test:

      Your Answer: Mann-Whitney U test

      Correct Answer: All of the above

      Explanation:

      All of the above answers are non-parametric tests.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      9
      Seconds
  • Question 26 - Which of the following nerves is responsible for the symptoms of a patient...

    Incorrect

    • Which of the following nerves is responsible for the symptoms of a patient with history of recurrent herpes simplex outbreaks on his face and presents with ophthalmic herpes zoster and a painful vesicle on the tip of his nose?

      Your Answer: Nasopalatine nerve

      Correct Answer: Nasociliary nerve

      Explanation:

      Hutchinson sign relates to involvement of the tip of the nose from facial herpes zoster. It implies involvement of the external nasal branch of the nasociliary nerve which is a branch of the ophthalmic division of the trigeminal nerve. The nasociliary branch of the trigeminal nerve innervates the apex and lateral aspect of the nose, as well as the cornea. Therefore, lesions on the side or tip of the nose should raise suspicion of ocular involvement.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      12.4
      Seconds
  • Question 27 - Regarding Clostridium tetani, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Germination of spores occurs in areas of tissue with high oxygen tension.

      Correct Answer: Infection is predominantly derived from animal faeces and soil.

      Explanation:

      Clostridium tetaniis a Gram positive, rod shaped, obligate anaerobic bacterium.The incubation period is quoted as anywhere between 4-21 days and can occur after several months but symptoms usually occur within the first 7 days after exposure.Approximately 80% of patients develop generalised tetanus. The commonest presenting feature of generalised tetanus is trismus (lockjaw), occurring in approximately 75% of affected individuals. Other clinical features include:Facial spasms (risus sardonicus)Opisthotonus (characteristic body shape during spasms)Neck stiffnessDysphagiaCalf and pectoral muscle rigidityFeverHypertensionTachycardiaSpasms can occur frequently and last for several minutes, they can continue to occur for up to 4 weeks. Current mortality rates are between 10 and 15%.Tetanic spasms are caused by the exotoxin tetanospasmin. The effects of tetanolysin are not fully understood but it is not believed to have clinical significance.Localised tetanus is a rare form of the disease, occurring in around 1% of affected individuals. Patients have persistent contraction of muscles in the same anatomic area as the injury. It may precede generalised tetanus.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      3.8
      Seconds
  • Question 28 - Which of the following is required for vitamin B12 absorption: ...

    Incorrect

    • Which of the following is required for vitamin B12 absorption:

      Your Answer: Pancreatic polypeptide

      Correct Answer: Intrinsic factor

      Explanation:

      Intrinsic factor is essential for the absorption of the small amounts of vitamin B12 normally present in the diet from the terminal ileum. The parietal cells of the stomach produce intrinsic factor, and following a gastrectomy, the absorption of vitamin B12 will be markedly reduced, and a deficiency state will exist.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      10.1
      Seconds
  • Question 29 - Which of the following is NOT a typical side effect of opioid analgesics:...

    Incorrect

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

      Your Answer: Dependence

      Correct Answer: Diarrhoea

      Explanation:

      All opioids have the potential to cause:Gastrointestinal effects – Nausea, vomiting, constipation, difficulty with micturition (urinary retention), biliary spasmCentral nervous system effects – Sedation, euphoria, respiratory depression, miosisCardiovascular effects – Peripheral vasodilation, postural hypotensionDependence and tolerance

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      38.4
      Seconds
  • Question 30 - Which of the following types of food is most commonly implicated in anaphylactic...

    Incorrect

    • Which of the following types of food is most commonly implicated in anaphylactic reactions:

      Your Answer:

      Correct Answer: Nuts

      Explanation:

      Anaphylaxis can be triggered by any of a very broad range of triggers, but those most commonly identified include food, drugs, latex and venom. Of foods, nuts are the most common cause; muscle relaxants, antibiotics, NSAIDs and aspirin are the most commonly implicated drugs. Food is the commonest trigger in children and drugs the commonest in adults. A significant number of cases are idiopathic. Most reactions occur over several minutes; rarely, reactions may be slower in onset. The speed of onset of the reaction depends on the trigger e.g. intravenous medications will cause a more rapid onset than stings which in turn will cause a more rapid onset than ingestion of food.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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