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  • Question 1 - The average BP reading on ambulatory blood pressure monitoring for a 59-year-old Caucasian...

    Incorrect

    • The average BP reading on ambulatory blood pressure monitoring for a 59-year-old Caucasian man is 152/96 mmHg (ABPM).

      The first-line drug treatment for this patient would be which of the following? Please only choose ONE answer.

      Your Answer: Bendroflumethiazide

      Correct Answer: Amlodipine

      Explanation:

      An ambulatory blood pressure reading of >150/95 is classified as stage 2 hypertension, according to the NICE care pathway for hypertension, and the patient should be treated with an antihypertensive drug.

      A calcium-channel blocker, such as amlodipine, would be the most appropriate medication for a 59-year-old Caucasian man.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 2 - A blood culture was performed from a sample taken from a patient. It...

    Incorrect

    • A blood culture was performed from a sample taken from a patient. It was noted that a Gram-positive coccus organism was grown.

      Among the following microorganisms, which is considered an example of a Gram-positive coccus?

      Your Answer:

      Correct Answer: Staphylococcus aureus

      Explanation:

      Bacillus cereus = Gram-positive bacillus
      Neisseria meningitidis = Gram-negative coccus
      Salmonella enterica & Escherichia coli = Gram-negative bacilli

      In Gram staining, crystal violet is a purple stain that is used to stain the bacteria first. The stained bacteria are decolorized and then stained with a red stain, which is safranin. Bacteria with thick cell walls keep the purple stain and are called Gram-positive. Thin-walled bacteria are easily decolorized so when safranin, the red stain, is placed on the organisms, they become red or Gram-negative.
      The Staphylococci that are associated with infections in humans are colonizers of various skin and mucosal surfaces. Because the carrier state is common among the human population, infections are frequently acquired when the colonizing strain gains entrance to a normally sterile site as a result of trauma or abrasion to the skin or mucosal surface.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
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  • Question 3 - Co-amoxiclav is used first line for which of the following indications: ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 4 - Insulin is a very important peptide hormone produced by the islets of Langerhans...

    Incorrect

    • Insulin is a very important peptide hormone produced by the islets of Langerhans in the pancreas.
      Insulin is synthesised by which of the following cell types within the islets of Langerhans? Select ONE answer only.

      Your Answer:

      Correct Answer: Beta cells

      Explanation:

      Insulin is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas. Insulin is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds. Proinsulin is synthesised as a single-chain peptide. Within storage granules, a connecting peptide (C peptide) is removed by proteases to yield insulin. Insulin release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin, but most output is driven by the rise in plasma glucose concentration that occurs after a meal. The effects of insulin are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
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  • Question 5 - The second generation antihistamine, cetirizine is a less-sedating antihistamine than the older antihistamine,...

    Incorrect

    • The second generation antihistamine, cetirizine is a less-sedating antihistamine than the older antihistamine, chlorphenamine because:

      Your Answer:

      Correct Answer: It is less lipid-soluble so less able to cross the blood brain barrier.

      Explanation:

      All older antihistamines such as chlorphenamine cause sedation. The newer antihistamines e.g. cetirizine cause less sedation and psychomotor impairment than the older antihistamines because they are much less lipid soluble and penetrate the blood brain barrier only to a slight extent.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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  • Question 6 - Which of the following anatomic structures will gallstones most likely lodge into, and...

    Incorrect

    • Which of the following anatomic structures will gallstones most likely lodge into, and cause cholestasis?

      Your Answer:

      Correct Answer: Hartmann’s pouch

      Explanation:

      Hartmann’s pouch is a diverticulum that can occur at the neck of the gallbladder. It is one of the rarest congenital anomalies of the gallbladder. Hartmann’s gallbladder pouch is a frequent but inconsistent feature of normal and pathologic human gallbladders. It is caused by adhesions between the cystic duct and the neck of the gallbladder. As a result, it is classified as a morphologic rather than an anatomic entity.

      There is a significant association between the presence of Hartmann’s pouch and gallbladder stones. It is the most common location for gallstones to become lodged and cause cholestasis.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
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  • Question 7 - You're currently treating an infection in a patient and trying to figure out...

    Incorrect

    • You're currently treating an infection in a patient and trying to figure out which antibiotic would be best.

      Which of the following antimicrobial drugs inhibits the formation of cell walls?

      Your Answer:

      Correct Answer: Cefuroxime

      Explanation:

      Cefuroxime and other cephalosporin antibiotics are bactericidal ß-lactam antibiotics. They work similarly to penicillins in that they prevent cross-linking between the linear peptidoglycan polymer chains that make up the bacterial cell wall. As a result, they prevent the formation of cell walls.
      The following is a summary of the various mechanisms of action of various types of antimicrobial agents:

      1) Inhibition of cell wall synthesis
      Penicillins
      Cephalosporins
      Vancomycin

      2) Disruption of cell membrane function
      Polymyxins
      Nystatin
      Amphotericin B

      3) Inhibition of protein synthesis
      Macrolides
      Aminoglycosides
      Tetracyclines
      Chloramphenicol

      4) Inhibition of nucleic acid synthesis
      Quinolones
      Trimethoprim
      5-nitroimidazoles
      Rifampicin

      5) Anti-metabolic activity
      Sulphonamides
      Isoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 8 - A 53-year-old man arrives at the emergency department complaining of visual impairment in...

    Incorrect

    • A 53-year-old man arrives at the emergency department complaining of visual impairment in his right eye. On examination, you notice that neither his right nor left pupil constricts when you shine a light in his right eye. When you flash a light in his left eye, the pupils of both his left and right eyes constrict. Which of the following nerves is the most likely to be affected:

      Your Answer:

      Correct Answer: Optic nerve

      Explanation:

      In full optic nerve palsy, the afferent pupillary light reflex is lost. Because the afferent optic nerve does not sense light flashed in the afflicted eye, the ipsilateral direct and contralateral consensual reflexes are gone. However, the contralateral direct and ipsilateral consensual reflexes are intact because the efferent oculomotor nerve is normal.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
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  • Question 9 - The monospot test for infectious mononucleosis uses which of the following types...

    Incorrect

    • The monospot test for infectious mononucleosis uses which of the following types of red blood cell?

      Your Answer:

      Correct Answer: Horse red blood cells

      Explanation:

      Infectious mononucleosis can be diagnosed using specific EBV antibodies and a variety if unrelated non-EBV heterophile antibodies. These antibodies can be detected by two main screening tests:

      The monospot test uses horse red blood cells. It agglutinates in the presence of heterophile antibodies.

      Sheep red blood cells is used in Paul-Bunnell test. The blood agglutinates in the presence of heterophile antibodies.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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  • Question 10 - An elderly female with a diagnosed psychiatric illness was prescribed prochlorperazine for her...

    Incorrect

    • An elderly female with a diagnosed psychiatric illness was prescribed prochlorperazine for her complaints of dizziness and nausea. Two days later, she returned to the clinic with no improvement in the symptoms.

      Which one of the following is the mechanism of action of prochlorperazine?

      Your Answer:

      Correct Answer: Dopamine receptor antagonism

      Explanation:

      Prochlorperazine is a phenothiazine drug as it is categorized as a first-generation antipsychotic. It mainly blocks the D2 (dopamine 2) receptors in the brain. Along with dopamine, it also blocks histaminergic, cholinergic, and noradrenergic receptors.

      It exerts its antiemetic effect via dopamine (D2) receptor antagonist. It is used to treat nausea and vomiting of various causes, including labyrinthine disorders.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
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