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  • Question 1 - You are giving a teaching session to a group of final year medical...

    Incorrect

    • You are giving a teaching session to a group of final year medical students regarding lower limb neurology. Which of the following clinical features would be expected in an obturator nerve palsy:

      Your Answer: Weakness of hip extension

      Correct Answer: Weakness of hip adduction

      Explanation:

      Damage to the obturator nerve results in weak adduction of the hip with lateral swinging of the limb during walking due to unopposed abduction.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      3
      Seconds

  • Question 2 - A 34-year-old man presented to the emergency room after being involved in a...

    Incorrect

    • A 34-year-old man presented to the emergency room after being involved in a road traffic accident. Upon observation and examination, it was noted that he was hypotensive and has muffled heart sounds. It was suspected that he has pericardial effusion, so an emergency pericardiocentesis was to be performed.

      In performing pericardiocentesis for suspected pericardial effusion, which of the following anatomical sites are at risk of being punctured?

      Your Answer:

      Correct Answer: 1 cm below the left xiphocostal angle

      Explanation:

      Pericardiocentesis is a procedure done to remove fluid build-up in the sac around the heart known as the pericardium. The pericardium can be tapped from almost any reasonable location on the chest wall. However, for the usual blind pericardiocentesis, the subxiphoid approach is preferred. Ideally, 2-D echocardiography is used to guide needle insertion and the subsequent path of the needle/catheter.

      In the subxiphoid approach, the needle is inserted 1 cm inferior to the left xiphocostal angle with an angle of 30 degrees from the patient’s chest with a direction towards the left mid-clavicle.

      The fingers may sense a distinct give when the needle penetrates the parietal pericardium. Successful removal of fluid confirms the needle’s position.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      0
      Seconds

  • Question 3 - A 63 year old lady presents to ED with a persistent cough and...

    Incorrect

    • A 63 year old lady presents to ED with a persistent cough and red currant jelly sputum. She has a history of chronic alcohol abuse and has an X-ray which demonstrates a cavitating pneumonia. The most likely causative pathogen is:

      Your Answer:

      Correct Answer: Klebsiella pneumoniae

      Explanation:

      One of the results of Klebsiella pneumoniae is pneumonia that is usually a very severe infection. It is characterised by thick, bloody sputum (red currant jelly sputum), and is associated with complications like lung abscess, cavitation, necrosis, empyema and pleural effusions.

    • This question is part of the following fields:

      • Infections
      • Microbiology
      0
      Seconds

  • Question 4 - Given a patient with dislocation of the patella, which muscle is the most...

    Incorrect

    • Given a patient with dislocation of the patella, which muscle is the most important to address during rehabilitation to prevent recurrent dislocation?

      Your Answer:

      Correct Answer: Vastus medialis

      Explanation:

      Patellar dislocation is a disabling musculoskeletal disorder which predominantly affects younger people who are engaged in multidirectional physically active pursuits. Conservative (non-operative) treatment is the treatment of choice for FTPD (first time patellar dislocation). Quadriceps strengthening exercises are considered one of the principal management aims for people following FTPD. A United Kingdom (UK) survey of physiotherapy practice has shown that quadriceps strengthening and specific-vastus medialis obliquus (VMO) or distal vastus medialis (VM) muscle strengthening or recruitment exercises were two of the most frequently used interventions for this population. Specific VM exercises are favoured in some quarters based on the assumption that the VM has an important role in preventing excessive lateral patellar translation.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 5 - Which of the following blood groups is the universal donor: ...

    Incorrect

    • Which of the following blood groups is the universal donor:

      Your Answer:

      Correct Answer: O

      Explanation:

      Blood group O has no antigens, but both anti-A and anti-B antibodies and thus is the universal donor.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
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  • Question 6 - Compression of this nerve can cause weakness in the left leg while walking...

    Incorrect

    • Compression of this nerve can cause weakness in the left leg while walking and thigh adduction weakness at the hip joint.

      Your Answer:

      Correct Answer: Obturator nerve

      Explanation:

      The obturator nerve is a sensory and motor nerve that emerges from the lumbar plexus and innervates the thigh.

      This nerve supplies motor innervation to the medial compartment of the thigh, making it necessary for thigh adduction.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 7 - A 17-year-old male presenting in the department has a history of C3 deficiency.

    C3...

    Incorrect

    • A 17-year-old male presenting in the department has a history of C3 deficiency.

      C3 deficiency is associated with all of the following EXCEPT?

      Your Answer:

      Correct Answer: Hereditary angioedema

      Explanation:

      C1-inhibitor deficiency is the cause of hereditary angioedema not C3 deficiency,

      All the other statements are correct

    • This question is part of the following fields:

      • General Pathology
      • Pathology
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  • Question 8 - How does an action potential in the motor end plate rapidly spread to...

    Incorrect

    • How does an action potential in the motor end plate rapidly spread to the central portions of the muscle cells?

      Your Answer:

      Correct Answer: Transverse tubules

      Explanation:

      When the concentration of intracellular Ca2+rises, muscle contraction occurs. The pathway of an action potential is down tube-shaped invaginations of the sarcolemma called T-tubules (transverse tubules). These penetrate throughout the muscle fibre and lie adjacent to the terminal cisternae of the sarcoplasmic reticulum. The voltage changes in the T-tubules result in the opening of sarcoplasmic reticulum Ca2+channels and there is there is release of stored Ca2+into the sarcoplasm. Thus muscle contraction occurs via excitation-contraction coupling (ECC) mechanism.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
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  • Question 9 - Which of the following statements about neutrophils is TRUE: ...

    Incorrect

    • Which of the following statements about neutrophils is TRUE:

      Your Answer:

      Correct Answer: Neutrophils are typically the first immune cell to arrive to a site of injury.

      Explanation:

      Neutrophils are the most numerous peripheral blood leukocytes, accounting for 50-70 percent of all circulating white cells. Neutrophils have a compact nucleus with two to five lobes and a pale cytoplasm with an irregular shape containing numerous fine pink-blue or grey-blue granules. The granules are classified as primary, which emerges during the promyelocyte stage, and secondary, which develop at the myelocyte stage and predominate in the mature nucleus.

      The lifespan of neutrophils in the blood is only 6 – 10 hours. In response to tissue damage, cytokines and complement proteins, neutrophils migrate from the bloodstream to the site of insult within minutes, where they destroy pathogens by phagocytosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
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  • Question 10 - You review a patient with urinary sepsis and decide to start her...

    Incorrect

    • You review a patient with urinary sepsis and decide to start her on gentamicin.

      Which statement about gentamicin is true?

      Your Answer:

      Correct Answer: Ototoxicity is a dose-related effect

      Explanation:

      Gentamicin, an aminoglycoside antibiotic, acts by binding to the 30S subunit of the bacterial ribosome inhibiting the binding of aminoacyl-tRNA, and thus prevents initiation of protein synthesis.

      Gentamicin is given by injection because it is NOT absorbed orally.

      It is excreted in the kidneys by glomerular filtration

      Gentamicin is not to be used for the treatment of Neisseria meningitidis, Neisseria gonorrhoea, or Legionella pneumophila.There is a risk of patient going into shock from lipid A endotoxin release.

      Two of its most notable side effects are hearing loss reversible nephrotoxicity and which are both dose-related and levels should be monitored in patients.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 11 - Which of the following is NOT a contraindication to the use of diazepam: ...

    Incorrect

    • Which of the following is NOT a contraindication to the use of diazepam:

      Your Answer:

      Correct Answer: Acute alcohol withdrawal

      Explanation:

      Benzodiazepines are used to treat symptoms in patients with acute alcohol withdrawal syndrome.
      Benzodiazepines are contraindicated in:
      Respiratory depression
      Marked neuromuscular respiratory weakness, such as unstable myasthenia gravis
      Obstructive sleep apnoea syndrome (symptoms may be aggravated)
      Severe hepatic impairment (the elimination half-life of diazepam may be prolonged; increased risk of coma)
      Phobic or obsessional states, chronic psychosis or hyperkinesis (paradoxical reactions may occur).

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 12 - Following the administration of a medication for a heart condition, a 69-year-old man...

    Incorrect

    • Following the administration of a medication for a heart condition, a 69-year-old man develops hypothyroidism.

      Which of the following drugs is most likely to be the cause?

      Your Answer:

      Correct Answer: Amiodarone

      Explanation:

      Amiodarone has a chemical structure that is similar to that of thyroxine and can bind to the nuclear thyroid receptor. It can cause both hypothyroidism and hyperthyroidism, though hypothyroidism is far more common, with 5-10% of patients suffering from it.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 13 - A patient presents with an adducted eye at rest which cannot abduct past...

    Incorrect

    • A patient presents with an adducted eye at rest which cannot abduct past the midline, which of the following cranial nerves is most likely to be affected:

      Your Answer:

      Correct Answer: Abducens nerve

      Explanation:

      Abducens nerve palsies result in a convergent squint at rest (eye turned inwards) with inability to abduct the eye because of unopposed action of the rectus medialis. The patient complains of horizontal diplopia when looking towards the affected side. With complete paralysis, the eye cannot abduct past the midline.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
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  • Question 14 - Which of the following muscles is NOT involved in depression of the mandible:...

    Incorrect

    • Which of the following muscles is NOT involved in depression of the mandible:

      Your Answer:

      Correct Answer: Masseter

      Explanation:

      Depression of the mandible is generated by the digastric, geniohyoid, mylohyoid and lateral pterygoid muscles on both side, assisted by gravity. The lateral pterygoid muscles are also involved as this movement also involves protraction of the mandible. The masseter muscle is a powerful elevator of the mandible.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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  • Question 15 - Regarding gentamicin, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding gentamicin, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Gentamicin typically causes acute glomerulonephritis in toxicity.

      Explanation:

      Gentamicin is the aminoglycoside of choice in the UK and is used widely for the treatment of serious infections. It has a broad spectrum but is inactive against anaerobes and has poor activity against haemolytic streptococci and pneumococci. When used for the blind therapy of undiagnosed serious infections it is usually given in conjunction with a penicillin or metronidazole (or both). The main toxic effects are nephrotoxicity and ototoxicity due to damage to the vestibulocochlear nerve (CN VIII).

      Gentamicin is contraindicated in myasthenia gravis and should be used with caution in renal disease which may result in accumulation and a greater risk of toxic side effects.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 16 - Regarding the refractory period, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding the refractory period, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Action potentials can occur in the relative refractory period but the amplitude of the action potential is smaller.

      Explanation:

      Following the action potential, Na+channels remain inactive for a time in a period known as the absolute refractory period where they cannot be opened by any amount of depolarisation. Following this there is a relative refractory period where the temporary hyperpolarisation (due to delayed closure of rectifier K+channels) makes the cell more difficult to depolarise and an action potential can be generated only in response to a larger than normal stimulus. The refractory period limits the frequency at which action potentials can be generated, and ensures that, once initiated, an action potential can travel only in one direction. An action potential is an all or nothing response so the amplitude of the action potential cannot be smaller.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
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  • Question 17 - When there is the presence of distended and engorged veins in the umbilical...

    Incorrect

    • When there is the presence of distended and engorged veins in the umbilical area, which of the following portosystemic anastomoses has most likely occurred?

      Your Answer:

      Correct Answer: Para-umbilical veins and inferior epigastric vein

      Explanation:

      Caput medusae is a condition that consists of collateral veins radiating from the umbilicus and results from recanalization of the umbilical vein.

      Under normal conditions, the portal venous blood traverses the liver and drains into the inferior vena cava of the systemic venous circulation by way of the hepatic veins. This is the direct route. However, other, smaller communications exist between the portal and systemic systems, and they become important when the direct route becomes blocked. These communications are as follows:

      At the lower third of the oesophagus, the oesophageal branches of the left gastric vein (portal tributary) anastomose with the oesophageal veins draining the middle third of the oesophagus into the azygos veins (systemic tributary).

      Halfway down the anal canal, the superior rectal veins (portal tributary) draining the upper half of the anal canal anastomosis with the middle and inferior rectal veins (systemic tributaries), which are tributaries of the internal iliac and internal pudendal veins, respectively.

      The paraumbilical veins connect the left branch of the portal vein with the superficial veins of the anterior abdominal wall (systemic tributaries). The paraumbilical veins travel in the falciform ligament and accompany the ligamentum teres.

      The veins of the ascending colon, descending colon, duodenum, pancreas, and liver (portal tributary) anastomose with the renal, lumbar, and phrenic veins (systemic tributaries).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
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  • Question 18 - A 64-year-old woman had a humerus midshaft fracture due to tripping on a...

    Incorrect

    • A 64-year-old woman had a humerus midshaft fracture due to tripping on a curb and falling on her left arm. She might also have damaged which of the following structures?

      Your Answer:

      Correct Answer: Radial nerve and deep brachial artery

      Explanation:

      The radial nerve and brachial artery are most likely to be damaged in humerus fractures. They are tethered together to the bone and cannot withstand the forces applied to it as a result of the displacement.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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      Seconds

  • Question 19 - A 27 year old woman presents to ED having sustained a deep laceration...

    Incorrect

    • A 27 year old woman presents to ED having sustained a deep laceration to the dorsum of her ring finger whilst cooking. Her proximal interphalangeal joint is fixed in flexion and the distal interphalangeal joint is hyperextended. Which of the following structures in the digit has most likely been injured:

      Your Answer:

      Correct Answer: Insertion of the central slip of the extensor tendon

      Explanation:

      Damage to the central slip of the extensor digitorum tendon would result in loss of extension at the proximal interphalangeal joint resulting in a fixed flexion deformity of this joint, and hyperextension of the distal interphalangeal joint due to a loss of balancing forces. This is called the Boutonniere deformity.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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      Seconds

  • Question 20 - All of the following predisposes to lithium toxicity in patients taking long-term therapy...

    Incorrect

    • All of the following predisposes to lithium toxicity in patients taking long-term therapy EXCEPT:

      Your Answer:

      Correct Answer: Hypernatraemia

      Explanation:

      A common complication of long term lithium therapy results in most cases of lithium intoxication. It is caused by reduced excretion of the drug which can be due to several factors including deterioration of renal function, dehydration, hyponatraemia, infections, and co-administration of diuretics or NSAIDs or other drugs that may interact.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 21 - Vitamin D is a group of secosteroids that play a role in calcium...

    Incorrect

    • Vitamin D is a group of secosteroids that play a role in calcium and phosphate control. Vitamin D's hormonally active metabolite is 1,25-dihydroxycholecalciferol.

      Which enzyme hydroxylates 25-hydroxycholecalciferol to form 1,25-dihydroxycholecalciferol? 

      Your Answer:

      Correct Answer: 1-alpha-hydroxylase

      Explanation:

      The hormone-active metabolite of vitamin D is 1,25-dihydroxycholecalciferol (commonly known as calcitriol). Its activities raise calcium and phosphate levels in the bloodstream.

      In the presence of UVB light, 7-dehydrocholesterol is converted to cholecalciferol in the epidermal layer of the skin, resulting in 1,25-dihydroxycholecalciferol.

      Cholecalciferol is then converted to 25-hydroxycholecalciferol in the endoplasmic reticulum of liver hepatocytes by 25-hydroxylase (calcifediol).

      Finally, 1-alpha-hydroxylase converts 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol in the kidney. The key regulatory point in the formation of 1,25-dihydroxycholecalciferol is 1-alpha-hydroxylase, which is induced by parathyroid hormone or hypophosphatemia.

      The following are the primary effects of 1,25-dihydroxycholecalciferol:
      Calcium and phosphate absorption in the small intestine is increased.
      Calcium reabsorption in the kidneys is increased.
      Increases phosphate reabsorption in the kidneys.
      Increases the action of osteoclastic bacteria (increasing calcium and phosphate resorption from bone)
      Inhibits the action of 1-alpha-hydroxylase in the kidneys (negative feedback)

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
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  • Question 22 - A 29-year-old man has been complaining about his recent headaches. Detailed history was...

    Incorrect

    • A 29-year-old man has been complaining about his recent headaches. Detailed history was taken and a neurological examination was performed.

      Which of the following cranial nerves is correctly paired with its lesion?

      Your Answer:

      Correct Answer: The oculomotor nerve: the eye appears to look ‘down and out’

      Explanation:

      The following are the lesions of the cranial nerves:
      1. Olfactory nerve (I)
      Reduced taste and smell, but not to ammonia which stimulates the pain fibres carried in the trigeminal nerve

      2. Optic nerve (II)
      Manifested by visual field defects, pupillary abnormalities, optic neuritis, optic atrophy, papilledema

      3. Oculomotor nerve (III)
      A fixed, dilated pupil which doesn’t accommodate, ptosis, complete internal ophthalmoplegia (masked by ptosis), unopposed lateral rectus causes outward deviation of the eye. If the ocular sympathetic fibres are also affected behind the orbit, the pupil will be fixed but not dilated.

      4. Trochlear nerve (IV)
      Diplopia due to weakness of downward and inward eye movement. The most common cause of a pure vertical diplopia. The patient tends to compensate by tilting the head away from the affected side.

      5. Trigeminal nerve (V)
      Reduced sensation or dysesthesia over the affected area. Weakness of jaw clenching and side-to-side movement. If there is a lower motor neuron (LMN) lesion, the jaw deviates to the weak side when the mouth is opened. There may be fasciculation of temporalis and masseter.

      6. Abducens nerve (VI)
      Inability to look laterally. The eye is deviated medially because of unopposed action of the medial rectus muscle.

      7. Facial nerve (VII)
      Facial weakness. In an LMN lesion the forehead is paralysed – the final common pathway to the muscles is destroyed; whereas the upper facial muscles are partially spared in an upper motor neurone (UMN) lesion because of alternative pathways in the brainstem. There appear to be different pathways for voluntary and emotional movement. CVAs usually weaken voluntary movement, often sparing involuntary movements (e.g., spontaneous smiling). The much rarer selective loss of emotional movement is called mimic paralysis and is usually due to a frontal or thalamic lesion.

      8. Vestibulocochlear nerve (VIII)
      Unilateral sensorineural deafness, tinnitus. Slow-growing lesions seldom present with vestibular symptoms as compensation has time to occur.

      9. Glossopharyngeal nerve (IX)
      Unilateral lesions do not cause any deficit because of bilateral corticobulbar connections. Bilateral lesions result in pseudobulbar palsy. These nerves are closely interlinked.

      10. Vagus nerve (X)
      Palatal weakness can cause ‘nasal speech’ and nasal regurgitation of food. The palate moves asymmetrically when the patient says ‘ahh’. Recurrent nerve palsy results in hoarseness, loss of volume and ‘bovine cough’.

      11. Accessory nerve (XI)
      Weakness and wasting of sternocleidomastoid and trapezius muscles

      12.Hypoglossal nerve (XII)
      An LMN lesion produces wasting of the ipsilateral side of the tongue, with fasciculation; and on attempted protrusion the tongue deviates towards the affected side, but the tongue deviates away from the side of a central lesion.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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  • Question 23 - A 35-year-old man suffered a severe road traffic accident and has been brought...

    Incorrect

    • A 35-year-old man suffered a severe road traffic accident and has been brought to the hospital. As part of his treatment, he requires a blood transfusion and experiences a transfusion reaction.

      The most common type of transfusion reaction is which of the following?

      Your Answer:

      Correct Answer: Febrile transfusion reaction

      Explanation:

      During or shortly after transfusion, febrile transfusion reactions, also known as non-haemolytic transfusion reactions, present with an unexpected temperature rise (38oC or 1oC above baseline, if baseline is 37oC). This is usually a one-off occurrence. The fever is sometimes accompanied by chills.

      The most common type of transfusion reaction is febrile transfusion reactions, which occur in about 1 in every 8 transfusions.

      The most common event leading to symptoms of febrile transfusion reactions is cytokine accumulation during storage of cellular components (especially platelet units). White cells secrete cytokines, and pre-storage leucodepletion has reduced this risk.

      Recipient antibodies (raised as a result of previous transfusions or pregnancies) reacting to donor human leukocyte antigen (HLA) or other antigens can also cause febrile transfusion reactions. Donor lymphocytes, granulocytes, and platelets all contain these antigens.

      Treatment is reassuring. Other causes should be ruled out, and antipyretics like paracetamol can help with fever relief. If another cause of fever is suspected, the transfusion should be stopped; however, if other causes of fever have been ruled out, it can be restarted at a slower rate.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 24 - Which of the following movements is controlled by the pectoralis major muscle? ...

    Incorrect

    • Which of the following movements is controlled by the pectoralis major muscle?

      Your Answer:

      Correct Answer: Flexion, adduction and medial rotation of the humerus

      Explanation:

      The pectoralis major is a muscle that runs across the top of the chest and connects to a ridge on the back of the humerus (the bone of the upper arm).

      Adduction, or lowering, of the arm (opposed to the deltoideus muscle) and rotation of the arm forward around the axis of the body are two of its main functions.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 25 - A 28-year-old known intravenous drug user has a history of persistent high-fever. On...

    Incorrect

    • A 28-year-old known intravenous drug user has a history of persistent high-fever. On examination you hear a harsh systolic murmur and the patient says a murmur has never been heard before in previous hospital visits. A diagnosis of endocarditis is suspect.

      Which of these antibacterial agents would be most appropriate to prescribe in this case?

      Your Answer:

      Correct Answer: Flucloxacillin and gentamicin

      Explanation:

      Endocarditis is infective or non infective inflammation (marantic endocarditis) of the inner layer of the heart and it often involves the heart valves.

      Risk factors include:
      Prosthetic heart valves
      Congenital heart defects
      Prior history of endocarditis
      Rheumatic fever
      Illicit intravenous drug use

      In the presentation of endocarditis, the following triad is often quoted:
      Persistent fever
      Embolic phenomena
      New or changing murmur

      Flucloxacillin and gentamicin are current recommended by NICE and the BNF for the initial ‘blind’ therapy in endocarditis.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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  • Question 26 - Regarding control of hospital acquired infection (HAI), which of the following statements is...

    Incorrect

    • Regarding control of hospital acquired infection (HAI), which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Chlorhexidine is an anti-staphylococcal agent.

      Explanation:

      Chlorhexidine is an anti-staphylococcal agent. Cleaning is the removal of foreign material from areas or objects to a point at which they are visually free from debris.  Disinfection is the reduction in the number of infectious particles. Isopropyl alcohol is not effective against C. difficile spores. Autoclaving is a method of sterilisation.

    • This question is part of the following fields:

      • Microbiology
      • Principles
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  • Question 27 - An infection causes an Addisonian crisis in a male patient with a known history...

    Incorrect

    • An infection causes an Addisonian crisis in a male patient with a known history of Addison's disease.

      Which of the following is NOT a well-known symptom of an Addisonian crisis?

      Your Answer:

      Correct Answer: Hyperglycaemia

      Explanation:

      Although Addisonian crisis is a rare illness, it can be fatal if it is misdiagnosed. Hypoglycaemia and shock are the most common symptoms of an Addisonian crisis (tachycardia, peripheral vasoconstriction, hypotension, altered conscious level, and coma).

      Other clinical characteristics that may be present are:
      Fever
      Psychosis
      Leg and abdominal pain
      Dehydration and vomiting
      Convulsions 

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
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  • Question 28 - All of the following statements are incorrect about insulin except: ...

    Incorrect

    • All of the following statements are incorrect about insulin except:

      Your Answer:

      Correct Answer: Proinsulin is cleaved into insulin and C peptide.

      Explanation:

      Proinsulin is synthesised as a single-chain peptide. A connecting peptide (C peptide) within storage granules is removed by proteases to yield insulin.

      Insulin:
      1. is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds.
      2. is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas.
      3. release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin. However, most output is driven by the rise in plasma glucose concentration that occurs after a meal.
      4. effects are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
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  • Question 29 - Severe vomiting and diarrhoea were reported by a 25-year-old man. He's dehydrated and...

    Incorrect

    • Severe vomiting and diarrhoea were reported by a 25-year-old man. He's dehydrated and needs intravenous fluids to rehydrate. You give him cyclizine as part of his treatment.

      What is cyclizine's main mechanism of action?

      Your Answer:

      Correct Answer: Antihistamine action

      Explanation:

      Cyclizine is a piperazine derivative that functions as an antihistamine (H1-receptor antagonist). To prevent nausea and vomiting, it is thought to act on the chemoreceptor trigger zone (CTZ) and the labyrinthine apparatus. It has a lower antimuscarinic effect as well.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
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  • Question 30 - A 23 year old woman has noticed her skin seems to have a...

    Incorrect

    • A 23 year old woman has noticed her skin seems to have a yellow tinge and presents to the emergency room. On examination she is found to have jaundice and mild splenomegaly, and blood tests show that her Hb is 79 g/L. She only takes one regular medication. The medication that is most likely to cause haemolytic anaemia is:

      Your Answer:

      Correct Answer: Mefenamic acid

      Explanation:

      Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) that is used short-term (7 days or less) to treat mild to moderate pain in adults and children who are at least 14 years old. Mefenamic acid is also used to treat menstrual pain. It has only minor anti-inflammatory properties and has occasionally been associated with diarrhoea and haemolytic anaemia. If these occur, treatment should be discontinued.

    • This question is part of the following fields:

      • Musculoskeletal
      • Pharmacology
      0
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