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  • Question 1 - In patients who are not at risk of hypercapnic respiratory failure but are...

    Incorrect

    • In patients who are not at risk of hypercapnic respiratory failure but are requiring oxygen, the oxygen saturations should be maintained at which of the following?

      Your Answer: 92 - 96%

      Correct Answer: 94 - 98%

      Explanation:

      Oxygen saturation should be 94 – 98% in most acutely ill patients with a normal or low arterial carbon dioxide (PaCO2). In some clinical situations, however, like cardiac arrest and carbon monoxide poisoning, it is more appropriate to aim for the highest possible oxygen saturation until the patient is stable.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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      Seconds

  • Question 2 - The only statement that is correct regarding diffusion is which of the following?...

    Incorrect

    • The only statement that is correct regarding diffusion is which of the following?

      Your Answer:

      Correct Answer: The permeability of a membrane is related to the membrane thickness and composition.

      Explanation:

      Passive diffusion is a process that describes the movement down a concentration gradient. This process accounts for movement across small distances like within the cytosol or across membranes. Factors that affect the diffusion of a substance across a membrane are the permeability (p) of the membrane, a difference in concentration across the membrane and the membrane area over which diffusion occurs. The membrane thickness and composition, and the diffusion coefficient of the substance also affects the permeability. Fick’s law describes the rate of diffusion of a substance within a solution, which can be modified to describe the rate of diffusion across a membrane.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
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  • Question 3 - Regarding hepatitis C, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding hepatitis C, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Anti-HCV IgG antibodies are diagnostic of acute infection.

      Explanation:

      Anti-HCV IgG antibodies indicate exposure to hepatitis C but this could be acute, chronic or resolved infection. If the antibody test is positive, HCV RNA should be tested for, which if positive indicates that a person has current infection with active hepatitis C.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 4 - A patient is diagnosed as having a glucagonoma. Her blood serum glucagon concentration...

    Incorrect

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

      Your Answer:

      Correct Answer: Glycolysis

      Explanation:

      Glucagon is a peptide hormone that is produced and secreted by alpha cells of the islets of Langerhans, which are located in the endocrine portion of the pancreas. The main physiological role of glucagon is to stimulate hepatic glucose output, thereby leading to increases in glycaemia. It provides the major counter-regulatory mechanism to insulin in maintaining glucose homeostasis.
      Hypoglycaemia is the principal stimulus for the secretion of glucagon but may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline.
      Glucagon then causes:
      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 5 - An 85-year-old woman is brought in from her nursing home. She arrives in...

    Incorrect

    • An 85-year-old woman is brought in from her nursing home. She arrives in the Emergency Department and appears confused. The staff member from the nursing home accompanying her informs you that she takes a water tablet.

      From her past medical history and records, you deduce that the water tablet is a loop diuretic.

      Which of the following parts of a nephron does a loop diuretic act on?

      Your Answer:

      Correct Answer: Ascending loop of Henlé

      Explanation:

      Loop diuretics are drugs used to manage and treat fluid overload associated with CHF, liver cirrhosis, and renal disease. The drugs commonly used are:
      Furosemide
      Bumetanide
      Torsemide
      Ethacrynic Acid

      Loop diuretics act on the apical membrane of the thick ascending loop of Henle and inhibit the Na-K-Cl cotransporter. This blocks the reabsorption of sodium and chloride and results in salt-water excretion. This relieves congestion and reduces oedema.

      Other diuretics act on the following part of the nephron:
      1. Thiazide diuretics – Na/Cl co-transporter in the distal convoluted tubule
      2. Osmotic diuretics – PCT and the loop of Henle
      3. Aldosterone antagonists – distal convoluted tubule
      4. Carbonic anhydrase inhibitors – inhibit the carbonic anhydrase and act on proximal tubular cells

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 6 - An analytical cohort study is done to compare the relationship between omega 3...

    Incorrect

    • An analytical cohort study is done to compare the relationship between omega 3 intake and occurrence of myocardial infarction (MI) among males aged over 65 years. The following are the data from the study:

      No. of subjects taking placebo: 100 men
      No. of subjects taking placebo who suffered an MI: 15 men

      No. of subjects taking omega 3: 100 men
      No. of subjects taking omega 3 who suffered an MI: 5 men

      Compute for the absolute risk in the treatment (omega 3) group.

      Your Answer:

      Correct Answer: 0.05

      Explanation:

      The absolute risk (AR) is the probability or chance of an event. It is computed as the number of events in treated or control groups, divided by the number of people in that group.

      AR = 5/100 = 0.05

    • This question is part of the following fields:

      • Evidence Based Medicine
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  • Question 7 - A patient is diagnosed with a Klebsiella infection.
    Which SINGLE statement regarding Klebsiella infections...

    Incorrect

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

      Your Answer:

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

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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  • Question 8 - Regarding the renin-angiotensin-aldosterone system (RAAS), which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the renin-angiotensin-aldosterone system (RAAS), which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Angiotensin II has a predominant vasoconstrictor effect on the efferent arteriole.

      Explanation:

      Angiotensin II constricts both the afferent and efferent arterioles, but preferentially increases efferent resistance. The net effect of the more prominent increase in efferent tone is that the intraglomerular pressure is stable or increased, thereby tending to maintain or even raise the GFR. Renin is produced by granular cells of the juxtaglomerular apparatus. Renin cleaves plasma angiotensinogen (produced in the liver) into angiotensin I. Angiotensin I is converted by angiotensin-converting enzyme (ACE) on pulmonary endothelial cells to angiotensin II. Angiotensin II acts to potentiate sympathetic activity (positive feedback).

    • This question is part of the following fields:

      • Physiology
      • Renal
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  • Question 9 - 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
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  • Question 10 - A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve...

    Incorrect

    • A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve injury. Which of the following will confirm the presence of an ulnar nerve injury?

      Your Answer:

      Correct Answer: Claw hand appearance

      Explanation:

      An ulnar injury may result in abnormal sensations in the little finger and ring finger, usually on the palm side, weakness, and loss of coordination of the fingers.

      A claw like deformity of the hand and wrist is present. Pain, numbness, decreased sensation, tingling, or burning sensation in the areas controlled by the nerve are also possible.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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