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  • Question 1 - An 11-year-old boy was brought to the emergency room due to fever and...

    Incorrect

    • An 11-year-old boy was brought to the emergency room due to fever and pain in the ears. Upon physical examination, it was observed that the mastoid area is erythematous and there is a presence of a boggy, tender mass. A diagnosis of acute mastoiditis was made.

      Which of the following parts of the temporal bone is most likely involved?

      Your Answer:

      Correct Answer: Petrous part

      Explanation:

      Mastoiditis is the inflammation of a portion of the temporal bone referred to as the mastoid air cells. The mastoid air cells are epithelium lined bone septations that are continuous with the middle ear cavity.

      The temporal bone is composed of four parts: the mastoid process, the petrous pyramid, the squamous, and tympanic portions. The mastoid process and the petrous pyramid are the portions of particular interest because of the prevalence of suppurations within these parts of the temporal bone.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      6
      Seconds
  • Question 2 - Regarding Clostridium tetani, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Metronidazole is usually the antibiotic of choice for tetanus infection.

      Explanation:

      Clostridium tetani infection is predominantly derived from animal faeces and soil.  Clostridium tetani has exotoxin-mediated effects, predominantly by tetanospasmin which inhibits the release of GABA at the presynaptic membrane throughout the central and peripheral nervous system. Metronidazole has overtaken penicillin as the antibiotic of choice for treatment of tetanus (together with surgical debridement, tetanus toxoid immunisation, and human tetanus immunoglobulin).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 3 - A patient presents with pain in the wrist and a tingling in the...

    Incorrect

    • A patient presents with pain in the wrist and a tingling in the hand. On examination Tinel's test is positive and you diagnose carpal tunnel syndrome. Regarding the carpal tunnel, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: The tendons of the flexor digitorum profundus, flexor digitorum superficialis and flexor pollicis longus lie within a single synovial sheath.

      Explanation:

      Free movement of the tendons in the carpal tunnel is facilitated by synovial sheaths, which surround the tendons. All of the tendons of the FDP and FDS are contained within a single synovial sheath with a separate sheath enclosing the tendon of the FPL.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 4 - A foot drop is a sign of damage to which of the following...

    Incorrect

    • A foot drop is a sign of damage to which of the following nerves?

      Your Answer:

      Correct Answer: Deep fibular nerve

      Explanation:

      The deep fibular nerve was previously referred to as the anterior tibial nerve.

      It starts at the common fibular nerve bifurcation, between the fibula and the proximal part of the fibularis longus. Damage to this nerve can cause foot drop or loss of dorsiflexion since this nerve controls the anterior leg muscles.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 5 - A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited...

    Incorrect

    • A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited range of motion in the right elbow for the past two days. On examination, the right elbow is extremely tender with erythema and warmth of the overlying skin due to acute inflammation.

      Which ONE of the following statements is true with regards to acute inflammation?

      Your Answer:

      Correct Answer: Neutrophils are activated and adhere to the endothelium as a result of interaction with endothelial cell adhesion molecules

      Explanation:

      Acute inflammation is defined as inflammation occurring within minutes to hours in response to an injury lasting for less than two weeks.

      Acute inflammation
      Rapid onset (minutes to hours)
      Quick resolution (usually days)

      Chronic inflammation
      May last weeks, months, or years

      There are five cardinal signs of inflammation:
      1) Pain
      2) Redness
      3) Warmth
      4) Oedema
      5) Loss of function

      During acute inflammation, neutrophils are activated and attracted to the site of inflammation in response to various interleukins and cytokines. This process takes place via the following mechanism:
      1) Margination
      Neutrophils flow nearer the vessel wall rather than in the axial stream, which is referred to as margination
      2) Rolling along the surface of vascular endothelium
      3) Adhesion to the endothelium by interaction with adhesion molecules (ICAMS and VCAMS)
      4) Diapedesis is the movement of neutrophils from the endothelial cells into the interstitial space by squeezing through the gaps between adjacent endothelial cells

      Bradykinin and histamine are both responsible for vasodilation which causes oedema and decreases intravascular osmotic pressure.

      Neutrophils dominate early (<2 days)
      – Many in the bloodstream
      – Attach firmly to adhesion molecules
      – Apoptosis after 24-48hrs
      Monocytes/macrophages dominate late (>2 days)
      – Live longer
      – Replicate in tissues

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
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  • Question 6 - A 39-year-old guy comes to the emergency room with a persistent nasal bleed....

    Incorrect

    • A 39-year-old guy comes to the emergency room with a persistent nasal bleed. You suspect the bleeding is coming from Little's area based on your examination. Which of the blood vessels listed below is most likely to be involved:

      Your Answer:

      Correct Answer: Sphenopalatine and superior labial arteries

      Explanation:

      The Kiesselbach plexus is a vascular network formed by five arteries that supply oxygenated blood to the nasal septum, which refers to the wall separating the right and left sides of the nose. The five arteries that form the Kiesselbach plexus: the sphenopalatine artery, which branches from the maxillary artery originating behind the jawbone; the anterior ethmoidal artery, which branches from the ophthalmic artery behind the eye; the posterior ethmoidal artery, which also branches from the ophthalmic artery; the septal branch of the superior labial artery, which is a branch of the facial artery supplying blood to all of the superficial features of the face; and finally, the greater palatine artery, which is a terminal branch of the maxillary artery.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 7 - On reviewing the ECG of a patient with a history of intermittent palpitations,...

    Incorrect

    • On reviewing the ECG of a patient with a history of intermittent palpitations, you observe prolonged QT interval.

      Which of these can cause prolongation of the QT interval on the ECG?

      Your Answer:

      Correct Answer: Erythromycin

      Explanation:

      Syncope and sudden death due to ventricular tachycardia, particularly Torsades-des-pointes is seen in prolongation of the QT interval.

      The causes of a prolonged QT interval include:
      Erythromycin
      Amiodarone
      Quinidine
      Methadone
      Procainamide
      Sotalol
      Terfenadine
      Tricyclic antidepressants
      Jervell-Lange-Nielsen syndrome (autosomal dominant)
      Romano Ward syndrome (autosomal recessive)
      Hypothyroidism
      Hypocalcaemia
      Hypokalaemia
      Hypomagnesaemia
      Hypothermia
      Rheumatic carditis
      Mitral valve prolapse
      Ischaemic heart disease

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      0
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  • Question 8 - 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 4 months:

      Your Answer:

      Correct Answer: Rotavirus

      Explanation:

      At 4 months the following vaccines are given:
      Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B (3rd dose)
      Meningococcal group B (2nd dose)

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      0
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  • Question 9 - Which of the following is NOT an advantage of a cohort study used...

    Incorrect

    • Which of the following is NOT an advantage of a cohort study used to investigate the relationship between exposure to a risk factor and a future outcome:

      Your Answer:

      Correct Answer: Particularly suitable for rare diseases

      Explanation:

      Advantages: ideal for studying associations between an exposure and an outcome when the exposure is uncommon, the time sequence of events can be assessed, they can provide information on a wide range of disease outcomes, the absolute and relative risk of disease can be measured directly, they can give a direct estimation of disease incidence rates
      Disadvantages: costly and can take long periods of time if the outcome is delayed, subject to subject-selection and loss to follow-up bias, large sample size required for rare outcome of interest so it is not useful for rare diseases, prone to confounding

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      0
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  • Question 10 - Which of the following clinical features would you least expect to see in...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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  • Question 11 - A 19-year-old woman presents with dysuria and vaginal discharge. A swab was taken...

    Incorrect

    • A 19-year-old woman presents with dysuria and vaginal discharge. A swab was taken for culture. Culture results showed the presence of Neisseria gonorrhoeae infection. Treatment of azithromycin and doxycycline was started.

      Which of the following statements is considered correct regarding Neisseria gonorrhoeae?

      Your Answer:

      Correct Answer: Throat swabs can be used for diagnosis

      Explanation:

      Neisseria gonorrhoeae is a Gram-negative diplococcus that causes gonorrhoea. Gonorrhoea is an acute pyogenic infection of nonciliated columnar and transitional epithelium; infection can be established at any site where these cells are found. Gonococcal infections are primarily acquired by sexual contact and occur primarily in the urethra, endocervix, anal canal, pharynx, and conjunctiva.

      In men, acute urethritis, usually resulting in purulent discharge and dysuria (painful urination), is the most common manifestation. The endocervix is the most common site of infection in women. Symptoms of infection, when present, include dysuria, cervical discharge, and lower abdominal pain. Some cases in women may be asymptomatic leading to complications such as pelvic inflammatory disease. Blood-borne dissemination occurs in less than 1% of all infections, resulting in purulent arthritis and rarely septicaemia. Fever and a rash on the extremities can also be present. Other conditions associated with N. gonorrhoeae include anorectal and oropharyngeal infections. Infections in these sites are more common in men who have sex with men but can also occur in women.

      Pharyngitis is the chief complaint in symptomatic oropharyngeal infections, whereas discharge, rectal pain, or bloody stools may be seen in rectal gonorrhoea. Approximately 30% to 60% of women with genital gonorrhoea have concurrent rectal infection. Newborns can acquire ophthalmia neonatorum, a gonococcal eye infection, during vaginal delivery through an infected birth canal.

      Specimens collected for the recovery of N. gonorrhoeae may come from genital sources or from other sites, such as the rectum, pharynx, and joint
      fluid. According to the 2010 STD Treatment guidelines, cephalosporins (e.g., ceftriaxone, cefixime) are currently recommended treatments.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 12 - The following are all examples of type I hypersensitivity EXCEPT for: ...

    Incorrect

    • The following are all examples of type I hypersensitivity EXCEPT for:

      Your Answer:

      Correct Answer: Contact dermatitis

      Explanation:

      Examples of type I reactions include:
      Allergic rhinitis
      Allergic conjunctivitis
      Allergic asthma
      Systemic anaphylaxis
      Angioedema
      Urticaria
      Penicillin allergy

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds
  • Question 13 - A 45-year-old man, a known case of epilepsy, visits his neurologist with complaints...

    Incorrect

    • A 45-year-old man, a known case of epilepsy, visits his neurologist with complaints of red, swollen gums.

      Which of the following medications is most likely responsible for his symptoms?

      Your Answer:

      Correct Answer: Phenytoin

      Explanation:

      Phenytoin is a commonly used antiepileptic drug. A well-recognized side-effect of phenytoin is gingival enlargement and occurs in about 50% of patients receiving phenytoin. It is believed that reduced folate levels may cause this, and evidence suggests that folic acid supplementation may help prevent this in patients starting phenytoin.

      As evidence suggests, drug-induced gingival enlargement may also improve by substituting with other anticonvulsant drugs and reinforcing a good oral hygiene regimen. Surgical excision of hyperplastic gingiva is often necessary to correct the aesthetic and functional impairment associated with this condition to manage it successfully.

      Phenytoin is also the only anticonvulsant therapy associated with the development of Dupuytren’s contracture.
      Other side effects are:
      1. Ataxia
      2. Drug-induced lupus
      3. Hirsutism
      4. Pruritic rash
      5. Megaloblastic anaemia
      6. Nystagmus

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
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  • Question 14 - Which of the following muscles are primarily involved in passive inspiration: ...

    Incorrect

    • Which of the following muscles are primarily involved in passive inspiration:

      Your Answer:

      Correct Answer: Diaphragm and external intercostal muscles

      Explanation:

      Passive inspiration is produced by contraction of the diaphragm (depressing the diaphragm) and the external intercostal muscles (elevating the ribs). In inspiration, elevation of the sternal ends of the ribs (‘pump handle’ movement), elevation of the lateral shafts of the ribs (‘bucket handle’ movement) and depression of the diaphragm result in expansion of the thorax in an anteroposterior, transverse and vertical direction respectively. This results in an increased intrathoracic volume and decreased intrathoracic pressure and thus air is drawn into the lungs.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
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  • Question 15 - A 64-year-old woman with a history of chronic breathlessness is referred for lung...

    Incorrect

    • A 64-year-old woman with a history of chronic breathlessness is referred for lung function testing.
      Which of the following statements regarding lung function testing is FALSE? Select ONE answer only.

      Your Answer:

      Correct Answer: In restrictive lung disease, the FVC is increased

      Explanation:

      In restrictive lung disorders there is a reduction in the forced vital capacity (FVC) and the forced expiratory volume in one second (FEV1). The decline in the FVC is greater than that of the FEV1, resulting in preservation of the FEV1/FVC ratio (>0.7%).
      In obstructive lung disease, FEV1is reduced to <80% of normal and FVC is usually reduced but to a lesser extent than FEV1. The FEV1/FVC ratio is reduced to <0.7.
      According to the latestNICE guidelines(link is external), airflow obstruction is defined as follows:
      Mild airflow obstruction = an FEV1 of >80% in the presence of symptoms
      Moderate airflow obstruction = FEV1 of 50-79%
      Severe airflow obstruction = FEV1 of 30-49%
      Very severe airflow obstruction = FEV1<30%.
      Spirometry is a poor predictor of durability and quality of life in COPD but can be used as part of the assessment of severity.
      COPD can only be diagnosed on spirometry if the FEV1 is <80% and FEV1/FVC ratio is < 0.7.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
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  • Question 16 - Which of the following ligaments supports the head of the talus? ...

    Incorrect

    • Which of the following ligaments supports the head of the talus?

      Your Answer:

      Correct Answer: Spring ligament

      Explanation:

      The spring-ligament complex is a significant medial arch stabilizer.

      The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 17 - Which of the following medications may lessen warfarin's anticoagulant effect: ...

    Incorrect

    • Which of the following medications may lessen warfarin's anticoagulant effect:

      Your Answer:

      Correct Answer: Phenytoin

      Explanation:

      Phenytoin will decrease the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
      Metronidazole will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism.
      NSAIDs, when given with Warfarin, increase anticoagulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
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  • Question 18 - A 42-year-old man presented to the emergency room after an incident of slipping...

    Incorrect

    • A 42-year-old man presented to the emergency room after an incident of slipping and falling onto his back and left hip. Upon physical examination, it was noted that he has pain on hip adduction, but normal hip flexion.

      Which of the following muscles was most likely injured in this case?

      Your Answer:

      Correct Answer: Pectineus

      Explanation:

      The hip adductors are a group of five muscles located in the medial compartment of the thigh. These muscles are the adductor longus, adductor brevis, adductor magnus, gracilis, and pectineus.

      The hip flexors consist of 5 key muscles that contribute to hip flexion: iliacus, psoas, pectineus, rectus femoris, and sartorius.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
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  • Question 19 - A 54-year-old woman presents with polyuria and polydipsia. She is known to suffer...

    Incorrect

    • A 54-year-old woman presents with polyuria and polydipsia. She is known to suffer from bipolar disorder, which has been well controlled by the use of lithium for many years.
      What is the SINGLE most likely diagnosis?

      Your Answer:

      Correct Answer: Nephrogenic diabetes insipidus

      Explanation:

      Diabetes insipidus is the inability to produce concentrated urine. It is characterised by the presence of excessive thirst, polyuria and polydipsia. There are two distinct types of diabetes insipidus:
      Cranial (central) diabetes insipidus and;
      Nephrogenic diabetes insipidus
      Cranial diabetes insipidus is caused by a deficiency of vasopressin (anti-diuretic hormone). Patients with cranial diabetes insipidus can have a urine output as high as 10-15 litres per 24 hours, but adequate fluid intake allows most patients to maintain normonatraemia. 30% of cases are idiopathic, and a further 30% are secondary to head injuries. Other causes include neurosurgery, brain tumours, meningitis, granulomatous disease (e.g. sarcoidosis) and drugs, such as naloxone and phenytoin. A very rare inherited form also exists that is associated with diabetes mellitus, optic atrophy, nerve deafness and bladder atonia.
      Nephrogenic diabetes insipidus is caused by renal resistance to the action of vasopressin. As with cranial diabetes insipidus, urine output is markedly elevated. Serum sodium levels can be maintained by secondary polydipsia or can be elevated. Causes of nephrogenic diabetes insipidus include chronic renal disease, metabolic disorders (e.g. hypercalcaemia and hypokalaemia) and drugs, including long-term lithium usage and demeclocycline.
      In view of the history of long-term lithium use, in this case, nephrogenic diabetes insipidus is the most likely diagnosis.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
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  • Question 20 - You evaluate a 80-year-old man who has a history of persistent heart failure...

    Incorrect

    • You evaluate a 80-year-old man who has a history of persistent heart failure and discover that he has generalised oedema.

      Which of the following claims regarding capillary hydrostatic pressure (P c) is false?

      Your Answer:

      Correct Answer: P c increases along the length of the capillary, from arteriole to venule

      Explanation:

      The capillary hydrostatic pressure (Pc) is normally between 15 and 30 millimetres of mercury. Pc Decreases along the capillary’s length, mirroring the arteriolar and venule pressures proximally and distally.
      Pc is determined by the ratio of arteriolar resistance (RA) to venular resistance (RV).

      When the RA/RV ratio is high, the pressure drop across the capillary is modest, and Pcis is close to venule pressure.

      When the ratio of RA/RV is low, the pressure drop across the capillary is considerable, and Pcis is close to arteriolar pressure.

      Pcis closer to the venule pressure and thus more responsive to changes in venous pressure than arteriolar pressure when RA/RV is high.

      Pcis the major force behind fluid pushing out of the capillary bed and into the interstitium.
      It is also the most variable of the forces affecting fluid transport at the capillary, partly because sympathetic-mediated arteriolar vasoconstriction varies.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
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  • Question 21 - A patient with history of weight loss and diarrhoea was found out to...

    Incorrect

    • A patient with history of weight loss and diarrhoea was found out to have Giardia lamblia in her stool since returning from a holiday to Nepal.

      Which of the following statements is considered true regarding the life cycle of Giardia lamblia?

      Your Answer:

      Correct Answer: Trophozoites attach to the intestinal wall via a specialised sucking disc

      Explanation:

      Cysts are resistant forms and are responsible for transmission of giardiasis. Both cysts and trophozoites can be found in the faeces (diagnostic stages). The cysts are hardy and can survive several months in cold water. Infection occurs by the ingestion of cysts in contaminated water, food, or by the faecal-oral route (hands or fomites).
      In the small intestine, excystation releases trophozoites (each cyst produces two trophozoites).
      Trophozoites multiply by longitudinal binary fission, remaining in the lumen of the proximal small bowel where they can be free or attached to the mucosa by a ventral sucking disk.
      Encystation occurs as the parasites transit toward the colon. The cyst is the stage found most commonly in non diarrheal faeces.
      Because the cysts are infectious when passed in the stool or shortly afterward, person-to-person transmission is possible. While animals are infected with Giardia, their importance as a reservoir is unclear.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
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  • Question 22 - Which of the following statements is incorrect regarding potassium replacement? ...

    Incorrect

    • Which of the following statements is incorrect regarding potassium replacement?

      Your Answer:

      Correct Answer: Oral potassium supplements are often required for patients taking spironolactone.

      Explanation:

      It is very seldom that potassium supplements are required with the small doses of diuretics given to treat hypertension. Potassium-sparing diuretics like spironolactone (rather than potassium supplements), are recommended for hypokalaemia prevention when diuretics are given to eliminate oedema, such as furosemide or the thiazides.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
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  • Question 23 - 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 is produced in which of the following cells? Select ONE answer only.

      Your Answer:

      Correct Answer: Alpha-cells in the pancreas

      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:
      Glycogenolysis
      Gluconeogenesis
      Lipolysis in adipose tissue
      The secretion of glucagon is also stimulated by:
      Adrenaline
      Cholecystokinin
      Arginine
      Alanine
      Acetylcholine
      The secretion of glucagon is inhibited by:
      Insulin
      Somatostatin
      Increased free fatty acids
      Increased urea production

      Glycolysis 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
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  • Question 24 - A 68-year-old man with BPH presents to the emergency department in significant pain...

    Incorrect

    • A 68-year-old man with BPH presents to the emergency department in significant pain secondary to urinary retention. What is the location of the neuronal cell bodies that are responsible for urinary bladder discomfort sensation?

      Your Answer:

      Correct Answer: Dorsal root ganglia of spinal cord levels S2, S3 and S4

      Explanation:

      The activation of stretch receptors with visceral afferents relayed through the pelvic nerve plexus and into the pelvic splanchnic nerves causes bladder pain. The sensory fibres of spinal nerves S2 – S4 enter the dorsal root ganglia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 25 - Which of the following is NOT a typical side effect of digoxin: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Hypokalaemia

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
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  • Question 26 - Which of the following is a primary action of calcitonin: ...

    Incorrect

    • Which of the following is a primary action of calcitonin:

      Your Answer:

      Correct Answer: Decreased bone resorption through inhibition of osteoclast activity

      Explanation:

      Calcitonin is a 32 amino acid polypeptide that is primarily synthesised and released by the parafollicular cells (C-cells) of the thyroid gland in response to rising or high levels of plasma Ca2+ions. Its primary role is to reduce the plasma calcium concentration, therefore opposing the effects of parathyroid hormone.
      Secretion of calcitonin is stimulated by:
      – Increased plasma calcium concentration
      – Gastrin
      – Pentagastrin
      – The main actions of calcitonin are:
      – Inhibition of osteoclastic activity (decreasing calcium and phosphate resorption from bone)
      – Stimulation of osteoblastic activity
      – Decreases renal calcium reabsorption
      – Decreases renal phosphate reabsorption

    • This question is part of the following fields:

      • Endocrine
      • Physiology
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  • Question 27 - On which of the following is preload primarily dependent? ...

    Incorrect

    • On which of the following is preload primarily dependent?

      Your Answer:

      Correct Answer: End-diastolic volume

      Explanation:

      Preload refers to the initial stretching of the cardiac myocytes before contraction. It is therefore related to muscle sarcomere length. The sarcomere length cannot be determined in the intact heart, and so, other indices of preload are used, like ventricular end-diastolic volume or pressure. The end-diastolic pressure and volume of the ventricles increase when venous return to the heart is increased, and this stretches the sarcomeres, which increase their preload.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 28 - What proportion of peripheral blood leukocytes are monocytes? ...

    Incorrect

    • What proportion of peripheral blood leukocytes are monocytes?

      Your Answer:

      Correct Answer: 5 - 10%

      Explanation:

      Monocytes account for around 5 to 10% of peripheral white cells. Monocytes in peripheral blood are generally bigger than other leukocytes and feature a large central oval or indented nucleus with clumped chromatin. The abundant cytoplasm staining blue and containing numerous fine vacuoles gives the appearance of ground glass. Cytoplasmic granules are another type of granule.

      Monocytes evolve from the granulocyte-macrophage progenitor to become monoblasts, promonocytes, monocytes, and tissue macrophages (in increasing order of maturity). Monocytes only stay in the bone marrow for a short time before exiting to circulate in the bloodstream for 20-40 hours before becoming macrophages.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
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  • Question 29 - All of the following statements are correct regarding the management of acute asthma...

    Incorrect

    • All of the following statements are correct regarding the management of acute asthma in adults except:

      Your Answer:

      Correct Answer: Intravenous aminophylline has been shown to result in significant additional bronchodilation compared to standard care.

      Explanation:

      There usually isn’t any additional bronchodilation with intravenous (IV) aminophylline compared to standard care with inhaled bronchodilators and steroids. IV aminophylline may cause side effects such as arrhythmias and vomiting. However, some additional benefit may be gained in patients with near-fatal asthma or life-threatening asthma with a poor response to initial therapy (5 mg/kg loading dose over 20 minutes unless on maintenance oral therapy, then continuous infusion of 0.5 – 0.7 mg/kg/hr).

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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  • Question 30 - Which nerve innervates the brachioradialis muscle? ...

    Incorrect

    • Which nerve innervates the brachioradialis muscle?

      Your Answer:

      Correct Answer: The radial nerve

      Explanation:

      Brachioradialis is innervated by the radial nerve (from the root values C5-C6) that stems from the posterior cord of the brachial plexus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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