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  • Question 1 - For an action potential to occur, which of the following must be true:...

    Incorrect

    • For an action potential to occur, which of the following must be true:

      Your Answer: The Na + efflux must exceed the K + influx

      Correct Answer: Depolarisation of the membrane must reach threshold potential

      Explanation:

      For an action potential to occur, the membrane must become more permeable to Na+and the Na+influx must be greater than the K+efflux. An action potential occurs when depolarisation of the membrane reaches threshold potential. The membrane must be out of the absolute refractory period, however an action potential can still occur in a relative refractory period but only in response to a larger than normal stimulus.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      2
      Seconds

  • Question 2 - A 29-year-old woman with a skin infection not responding to first-line antibiotics return...

    Incorrect

    • A 29-year-old woman with a skin infection not responding to first-line antibiotics return for a review clinic appointment. The result of her culture shows growth of methicillin-resistant Staphylococcus aureus (MRSA).

      Which among the following antibiotics is methicillin-resistant Staphylococcus aureus usually sensitive to?

      Your Answer:

      Correct Answer: Linezolid

      Explanation:

      Historically, MRSA has been treated successfully with outpatient oral sulphonamides, clindamycin, rifampin, doxycycline, or a combination of these agents. With the development of increasing drug resistance of MRSA to these traditional antimicrobials, there has been a search for more effective antibiotics. One recent study demonstrated that vancomycin, linezolid, and quinupristin-dalfopristin were the most effective antibiotics against multiple strains of MRSA.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 3 - A 20-year-old male patient lives in a travelling community and has never...

    Incorrect

    • A 20-year-old male patient lives in a travelling community and has never received any vaccinations. He presents to you with fever.

      Which of these statements concerning indications and contraindications for vaccination is FALSE?

      Your Answer:

      Correct Answer: Premature infants should have the their immunisation schedule adjusted for gestational age

      Explanation:

      All vaccines are contraindicated in individuals with:
      A confirmed anaphylactic reaction to a previous dose of the vaccine or a vaccine containing the same antigens.
      A confirmed anaphylactic reaction to a component in the vaccine e.g. neomycin

      Live attenuated vaccines are contraindicated in pregnancy except in cases where risk of infection is more than the risks of vaccination.

      During times of acute febrile illness, vaccination should be avoided.

      12 weeks should elapse after a dose of human immunoglobulin before a live vaccine is administered.

      The normal times recommended for immunization of full-term babies should also be applied to premature infants and correction for gestational age should NOT be implemented.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds

  • Question 4 - All of the following statements regarding Helicobacter pylori is considered true, except: ...

    Incorrect

    • All of the following statements regarding Helicobacter pylori is considered true, except:

      Your Answer:

      Correct Answer: Serum antibody levels should be used to check for successful eradication

      Explanation:

      Helicobacter pylori is a curved, non-spore forming, Gram-negative bacteria that is primarily linked to gastric infections. Once acquired, it colonizes the stomach for a long time and can cause a low-grade inflammatory process, producing a chronic superficial gastritis.

      H. pylori can be recovered from gastric biopsy materials. Samples must be transported quickly to the laboratory.
      Helicobacter infections usually are identified by nonculture methods. H. pylori can be presumptively identified in a gastric biopsy specimen by testing for the presence of a rapid urease reaction.

      Serologic testing is an important screening method for the diagnosis of H. pylori infection. It can also be diagnosed by faecal antigen detection, microscopic examination of stained gastric tissue, and DNA amplification tests.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 5 - In a ward round, you come across a patient's treatment chart prescribed an...

    Incorrect

    • In a ward round, you come across a patient's treatment chart prescribed an antibiotic to fight his infection. This antibiotic is an inhibitor of cell wall synthesis.

      Which of the following antimicrobial drugs is prescribed to this patient?

      Your Answer:

      Correct Answer: Benzylpenicillin

      Explanation:

      Penicillins and cephalosporins are the major antibiotics that inhibit bacterial cell wall synthesis. They inactivate transpeptidases that help cross-link peptidoglycans in cell walls.

      Isoniazid decreases the synthesis of mycolic acids in mycobacterium.

      Clarithromycin binds to the 50S subunit of ribosomes and inhibits protein synthesis.

      Metronidazole and the other 5-nitroimidazole agents inhibit nucleic acid synthesis by forming toxic free radical metabolites in the bacterial cell that damage DNA.

      Tetracycline bind to 30S and prevent attachment of aminoacyl-tRNA.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 6 - On review of a patient's serum and urine osmolality test result, you note...

    Incorrect

    • On review of a patient's serum and urine osmolality test result, you note that both osmolarities are decreased. There urine osmolality does not increase with fluid ingestion.

      What is the most likely cause?

      Your Answer:

      Correct Answer: Hyponatraemia

      Explanation:

      As part of the investigation of hyponatraemia, serum osmolality is commonly requested in combination with urine osmolality to aid diagnosis.

      When:
      Serum osmolality is decreased and urine osmolality is decreased with no intake of fluid, the causes are
      Hyponatraemia
      Overhydration
      Adrenocortical insufficiency
      Sodium loss (diuretic or a low-salt diet)

      Serum osmolality is normal or increased and urine osmolality is increased the causes include:
      Dehydration
      Hyperkalaemia
      Hyperglycaemia
      Hyponatremia
      Mannitol therapy
      Diabetes mellitus
      Alcohol ingestion
      Congestive heart failure
      Renal disease and uraemia

      Serum osmolality is normal or increased and urine osmolality is decreased the usual cause is diabetes insipidus

      Serum osmolality is decreased and urine osmolality is increased the usual cause is syndrome of inappropriate antidiuresis (SIAD)

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
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  • Question 7 - Gallstones are commonly found lodged in which of the following parts of the...

    Incorrect

    • Gallstones are commonly found lodged in which of the following parts of the gallbladder?

      Your Answer:

      Correct Answer: Neck

      Explanation:

      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 8 - A 29-year-old woman presents with night sweats, fever, and haemoptysis. A diagnosis of...

    Incorrect

    • A 29-year-old woman presents with night sweats, fever, and haemoptysis. A diagnosis of tuberculosis was suspected.

      Which of the following statements regarding the diagnosis of tuberculosis is considered correct?

      Your Answer:

      Correct Answer: Mycobacteria tuberculosis can be typed using a RFLP method

      Explanation:

      Although a variety of clinical specimens may be submitted to the
      laboratory to recover MTB and NTM, respiratory secretions such
      as sputum and bronchial aspirates are the most common. An
      early-morning specimen should be collected on three consecutive
      days, although recent studies have suggested that the addition of
      a third specimen does not significantly increase the sensitivity
      of detecting Mycobacteria.

      Mycobacterium tuberculosis appear red on acid-fast staining because they take up the primary stain, which is carbolfuchsin, and is not decolorized by the acid alcohol anymore.

      Culture on Lowenstein-Jensen medium should be read within 5 to 7 days after inoculation and once a week thereafter for up to 8 weeks.

      Nucleic acid amplification assays designed to detect M. tuberculosis complex
      bacilli directly from patient specimens can be performed in as little as 6 to 8 hours on processed specimens.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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  • Question 9 - A 35-year-old man suffers an open fracture of his forearm. The nerve that...

    Incorrect

    • A 35-year-old man suffers an open fracture of his forearm. The nerve that innervates the pronator quadratus muscle is damaged as a consequence of this injury.
      Which of the following nerves has been damaged in this case? Select ONE answer only.

      Your Answer:

      Correct Answer: The anterior interosseous nerve

      Explanation:

      Pronator quadratus is a small, square-shaped muscle that lies in the anterior compartment of the forearm. It arises from the distal fourth of the anterior surface of the ulna and inserts into the distal fourth of the anterior surface of the radius.
      Pronator quadratus is innervated by the anterior interosseous nerve. It receives its blood supply from the anterior interosseous artery, which is a branch of the common interosseous artery, which in turn is a branch of the ulnar artery.
      The main action of pronator quadratus is to assist pronator teres with pronation of the forearm. The deep fibres bind the radius and ulna together.
      The pronator quadratus muscle highlighted in blue (adapted from Gray’s Anatomy)

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 10 - Regarding the lumbar plexus, which of the following is a direct muscular branch?...

    Incorrect

    • Regarding the lumbar plexus, which of the following is a direct muscular branch?

      Your Answer:

      Correct Answer: Nerve to quadratus lumborum

      Explanation:

      The lumbar plexus gives rise to several branches which supply various muscles and regions of the posterior abdominal wall and lower limb. These branches include the Iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral and obturator nerves.

      In addition, the lumbar plexus gives off muscular branches from its roots, a branch to the lumbosacral trunk and occasionally an accessory obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 11 - A 22-year-old woman is brought in by ambulance from her GP surgery with...

    Incorrect

    • A 22-year-old woman is brought in by ambulance from her GP surgery with suspected meningitis. She has been given a dose of benzylpenicillin already.
      What is the mechanism of action of benzylpenicillin? Select ONE answer only.

      Your Answer:

      Correct Answer: Inhibition of cell wall synthesis

      Explanation:

      Penicillins and the other ß-lactam antibiotics are bactericidal. They produce their antimicrobial action by preventing cross-linkage between the linear peptidoglycan polymer chains that make up the bacterial cell wall. They, therefore, inhibit cell wall synthesis.
      An overview of the different mechanisms of action of the various types of antimicrobial agents is shown below:
      Mechanism of action
      Examples
      Inhibition of cell wall synthesis
      Penicillins
      Cephalosporins
      Vancomycin
      Disruption of cell membrane function
      Polymyxins
      Nystatin
      Amphotericin B
      Inhibition of protein synthesis
      Macrolides
      Aminoglycosides
      Tetracyclines
      Chloramphenicol
      Inhibition of nucleic acid synthesis
      Quinolones
      Trimethoprim
      5-nitroimidazoles
      Rifampicin
      Anti-metabolic activity
      Sulfonamides
      Isoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 12 - An 11-year-old girl presents with a 5-day history of persistent fever despite regular...

    Incorrect

    • An 11-year-old girl presents with a 5-day history of persistent fever despite regular paracetamol, throbbing left ear pain, ear discharge and deafness. Her parents have observed that she is not her usual self, not eating well, and has been lethargic. On examination there is a tender swelling in the post auricular region on the left hand side.

      What is the most likely causative organism?

      Your Answer:

      Correct Answer: Streptococcus pneumonia

      Explanation:

      Acute mastoiditis is a complication (rare) of acute otitis media (AOM) and the commonest causative organism is Streptococcus pneumoniae.

      Generally, acute mastoiditis presents with:
      Pyrexia
      Recent history of AOM
      Mastoid swelling and erythema
      Otalgia
      Otorrhoea and perforation of tympanic membrane
      Post-auricular pain
      Protrusion of the ears

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 13 - 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
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      Seconds

  • Question 14 - You assess a patient that has suffered a nerve injury that has paralysed...

    Incorrect

    • You assess a patient that has suffered a nerve injury that has paralysed her left latissimus dorsi muscle.
      Latissimus dorsi receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer:

      Correct Answer: Thoracodorsal nerve

      Explanation:

      Latissimus dorsi originates from the lower part of the back, where it covers a wide area. It lies underneath the inferior fibres of trapezius superiorly, and trapezius is the most superficial back muscle.
      Superficial muscles of the back showing latissimus dorsi (from Gray’s Anatomy)
      Latissimus dorsi has a broad origin, arising from the spinous processes of T6-T12, the thoracolumbar fascia, the iliac crest and the inferior 3 or 4 ribs. The fibres converge into a tendon that inserts into the intertubercular groove of the humerus.
      Latissimus dorsi is innervated by the thoracodorsal nerve.
      Latissimus dorsi acts to extend, adduct and medially rotate the humerus. It, therefore, raises the body towards the arm during climbing.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 15 - Damage to this nerve affects the flexor digitorum longus. ...

    Incorrect

    • Damage to this nerve affects the flexor digitorum longus.

      Your Answer:

      Correct Answer: Tibial nerve

      Explanation:

      Like all muscles in the deep posterior compartment of the leg, flexor digitorum longus muscle is innervated by branches of the tibial nerve (root value L5, S1 and S2) which is a branch of sciatic nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 16 - A 52-year-old man develops pneumonia 3 days following an admission for investigation of...

    Incorrect

    • A 52-year-old man develops pneumonia 3 days following an admission for investigation of chest pain. He has coarse left basal crackles and evidence of consolidation in the left lower lobe of chest X-ray. He has no known drug allergies.
      According to the latest NICE guidelines, which of the following antibacterial agents would be most appropriate to prescribe in this case? Select ONE answer only.

      Your Answer:

      Correct Answer: Co-amoxiclav

      Explanation:

      Nosocomial infections are defined as those occurring within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation. They affect 1 in 10 patients admitted to hospital. Annually, this results in 5000 deaths with a cost to the National Health Service of a billion pounds. On average, a patient with hospital acquired infection spent 2.5-times longer in hospital, incurring additional costs of £3000 more than an uninfected patient. Intensive care units (ICU) have the highest prevalence of hospital-acquired infections in the hospital setting.
      The current recommendations by NICE and the BNF on the treatment of hospital acquired pneumonia are:
      Early onset infection(less than 5 days after admission to hospital): co-amoxiclav or cefuroxime for 7 days
      Late-onset infection(more than 5 days after admission to hospital): an antipseudomonal penicillin (e.g. piperacillin with tazobactam), a broad-spectrum cephalosporin (e.g. ceftazidime), or a quinolone (e.g. ciprofloxacin)
      If the patient developed a hospital-acquired pneumonia within 5 days of admission – co-amoxiclav would be the most appropriate choice.
      If the patient has developed a hospital-acquired pneumonia > 5 days after admission – ciprofloxacin would be the most appropriate choice from the list of options available.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
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  • Question 17 - Aldin is a 24-year-old male patient who arrives at the emergency department diagnosed...

    Incorrect

    • Aldin is a 24-year-old male patient who arrives at the emergency department diagnosed with psittacosis based on his symptoms and history of being a pigeon enthusiast. Which of the following is the causative bacteria of psittacosis?

      Your Answer:

      Correct Answer: Chlamydia psittaci

      Explanation:

      Chlamydia psittaci is a microorganism that is commonly found in birds.

      These bacteria can infect people and cause psittacosis. Psittacosis is an infectious disease that may cause high fever and pneumonia associated with headaches, altered mental state, and hepatosplenomegaly.

    • This question is part of the following fields:

      • Infections
      • Microbiology
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  • Question 18 - The resting membrane potential of a neurone is usually about: ...

    Incorrect

    • The resting membrane potential of a neurone is usually about:

      Your Answer:

      Correct Answer: -70 mV

      Explanation:

      In most neurones the resting potential has a value of approximately -70 mV. The threshold potential is generally around -55 mV. Initial depolarisation occurs as a result of a Na+influx through ligand-gated Na+channels. Action potential is an all or nothing response; because the size of the action potential is constant, the intensity of the stimulus is coded by the frequency of firing of a neuron. Repolarisation occurs primarily due to K+efflux.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 19 - A 29-year-old volunteer returns from a recent trip to the middle east with...

    Incorrect

    • A 29-year-old volunteer returns from a recent trip to the middle east with profuse watery diarrhoea. You make a diagnosis of cholera and organize a hospital admission for rehydration with intravenous fluids.

      What is the mechanism of action of cholera toxin?

      Your Answer:

      Correct Answer: ADP-ribosylation of the G regulatory protein

      Explanation:

      Cholera is caused by Vibrio cholerae, a motile, Gram-negative, curved bacillus. It is transmitted through water and food (especially seafood) and is primarily a disease seen in developing countries where there is poor sanitation and lack of safe water supplies.

      The cholera toxin leads to stimulation of adenyl cyclase, ADP-ribosylation of the G regulatory protein, inactivation of GTPase leading to active outpouring of NaCl.

      The cholera toxin consists of an A (the toxin) and B subunit. The B subunit attaches to the gut mucosa and presents the A subunit to the cell. The toxin stimulates adenyl cyclase by irreversible ADP-ribosylation of the GTP binding domain of adenyl cyclase leading to the opening of chloride channels resulting in an outpouring of NaCl and water into the lumen of the gut and causing secretory diarrhoea.

      Incubation period is between 2 and 5 days, but can be as short as just a few hours.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
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  • Question 20 - A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part...

    Incorrect

    • A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part in a powerlifting competition, he felt a painful snap at the front of his shoulder and chest. There is also the presence of bruising and swelling over the left side of his chest. A ruptured pectoralis major muscle was suspected upon examining the injured area.

      Which of the following statements regarding the surface markings of the pectoralis major muscle is considered correct?

      Your Answer:

      Correct Answer: It inserts into the lateral lip of the bicipital groove of the humerus

      Explanation:

      The pectoralis major is the superior most and largest muscle of the anterior chest wall. It is a thick, fan-shaped muscle that lies underneath the breast tissue and forms the anterior wall of the axilla.

      Its origin lies anterior surface of the medial half of the clavicle, the anterior surface of the sternum, the first 7 costal cartilages, the sternal end of the sixth rib, and the aponeurosis of the external oblique of the anterior abdominal wall.
      The insertion of the pectoralis major is at the lateral lip of the intertubercular sulcus of the humerus. There are 2 heads of the pectoralis major, the clavicular and the sternocostal, which reference their area of origin.
      The function of the pectoralis major is 3-fold and dependent on which heads of muscles are involved:
      – Flexion, adduction and medial rotation of the arm at the glenohumeral joint
      – Clavicular head causes flexion of the extended arm
      – Sternoclavicular head causes extension of the flexed arm

      Arterial supply of the pectoralis major, the pectoral artery, arises from the second branch of the axillary artery, the thoracoacromial trunk.

      The 2 heads of the pectoralis major have different nervous supplies. The clavicular head derives its nerve supply from the lateral pectoral nerve. The medial pectoral nerve innervates the sternocostal head. The lateral pectoral nerve arises directly from the lateral cord of the brachial plexus, and the medial pectoral nerve arises from the medial cord.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 21 - Regarding threadworms, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding threadworms, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: First line treatment of threadworms is with mebendazole.

      Explanation:

      First line treatment of threadworms is with mebendazole, with treatment of the whole family, and a repeat treatment after 2 weeks. Threadworms live in the large bowel, but direct multiplication of worms does not occur here. Threadworms most commonly infect children, and may be symptomatic or cause pruritus ani.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 22 - The most important nerves for inversion of the foot are: ...

    Incorrect

    • The most important nerves for inversion of the foot are:

      Your Answer:

      Correct Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is achieved by the tibialis anterior which is innervated by the deep fibular nerves, and the tibialis posterior muscles which is innervated by the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 23 - You are about to perform an emergency pericardiocentesis on a 26-year-old male who...

    Incorrect

    • You are about to perform an emergency pericardiocentesis on a 26-year-old male who was involved in a car accident and is suspected of having cardiac tamponade due to signs of hypotension, muffled heart sounds, and distended neck veins. Where should you insert the needle to relieve tamponade?

      Your Answer:

      Correct Answer: Inferior and to the left of the xiphochondral junction

      Explanation:

      Pericardiocentesis is a procedure that removes excess fluid from the pericardium. As a result, it’s used in cases of cardiac tamponade, which occurs when there’s too much fluid in the space around the heart.

      During the procedure, a needle and a small catheter are inserted 1 to 2 cm inferior and to the left of the xiphochondral junction into the pericardial cavity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 24 - Which coronary artery is mostly likely affected if an ECG shows a tombstone...

    Incorrect

    • Which coronary artery is mostly likely affected if an ECG shows a tombstone pattern in leads V2, V3 and V4?

      Your Answer:

      Correct Answer: Left anterior descending artery

      Explanation:

      Tombstoning ST elevation myocardial infarction can be described as a STEMI characterized by tombstoning ST-segment elevation. This myocardial infarction is associated with extensive myocardial damage, reduced left ventricle function, serious hospital complications and poor prognosis. Tombstoning ECG pattern is a notion beyond morphological difference and is associated with more serious clinical results.

      Studies have shown that tombstoning is more commonly found in anterior than non-anterior STEMI, thus, higher rates of left anterior descending artery disease are observed in patients with tombstoning pattern.

      The following ECG leads determine the location and vessels involved in myocardial infarction:

      ECG Leads Location Vessel involved
      V1-V2 Septal wall Left anterior descending
      V3-V4 Anterior wall Left anterior descending
      V5-V6 Lateral wall Left circumflex artery
      II, III, aVF Inferior wall Right coronary artery (80%) or Left circumflex artery (20%)
      I, aVL High lateral wall Left circumflex artery
      V1, V4R Right ventricle Right coronary artery
      V7-V9 Posterior wall Right coronary artery

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 25 - C-reactive protein (CRP) synthesis is predominantly stimulated by which of the following cytokines:...

    Incorrect

    • C-reactive protein (CRP) synthesis is predominantly stimulated by which of the following cytokines:

      Your Answer:

      Correct Answer: IL-6

      Explanation:

      Activated leukocytes, adipocytes, and endothelial cells all release interleukin 6 (IL-6), a significant proinflammatory cytokine. The main downstream mediator of the acute phase response is C-reactive protein, which is predominantly produced by IL-6–dependent hepatic biosynthesis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
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  • Question 26 - The fracture of the medial epicondyle will cause damage to the ulnar nerve....

    Incorrect

    • The fracture of the medial epicondyle will cause damage to the ulnar nerve. Which of the following motions would be impaired by this type of injury?

      Your Answer:

      Correct Answer: Adduction of the thumb

      Explanation:

      Fracture of the medial epicondyle is most likely to result in damage to the ulnar nerve.

      The three hypothenar muscles, two medial lumbricals, seven interossei, the adductor pollicis, and the deep head of the flexor pollicis brevis are all innervated by the deep branch of the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 27 - Diagnosis of HIV is predominantly made through which of the following: ...

    Incorrect

    • Diagnosis of HIV is predominantly made through which of the following:

      Your Answer:

      Correct Answer: Antibody detection

      Explanation:

      Diagnosis of HIV is predominantly made through detection of HIV antibody and p24 antigen. Viral load (viral PCR) and CD4 count are used to monitor progression of disease.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 28 - A 40-year-old man complains of pain and redness in his lower thigh due...

    Incorrect

    • A 40-year-old man complains of pain and redness in his lower thigh due to an insect bite. He was diagnosed with cellulitis. Select the first-line antibiotic for cellulitis.

      Your Answer:

      Correct Answer: Flucloxacillin

      Explanation:

      Cellulitis is most commonly caused by bacteria from the group Aß-hemolytic streptococcus.

      Cellulitis can be caused by animal bites. For uncomplicated cellulitis, flucloxacillin is the first-line antibiotic. Because it is beta-lactamase stable, it is efficient against Staphylococcus aureus.

    • This question is part of the following fields:

      • Infections
      • Microbiology
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  • Question 29 - Which of the following is most likely affected in De Quervain's tenosynovitis? ...

    Incorrect

    • Which of the following is most likely affected in De Quervain's tenosynovitis?

      Your Answer:

      Correct Answer: Extensor pollicis brevis

      Explanation:

      De Quervain tenosynovitis is named after the Swiss surgeon, Fritz de Quervain, who first described it in 1895. It is a condition which involves tendon entrapment affecting the first dorsal compartment of the wrist. With this condition thickening of the tendon sheaths around the abductor pollicis longus and extensor pollicis brevis develops where the tendons pass in through the fibro-osseous tunnel located along the radial styloid at the distal wrist. Pain is exacerbated by thumb movement and radial and ulnar deviation of the wrist.

      The estimated prevalence of de Quervain tenosynovitis is about 0.5% in men and 1.3% in women with peak prevalence among those in their forties and fifties. It may be seen more commonly in individuals with a history of medial or lateral epicondylitis. Bilateral involvement is often reported in new mothers or child care providers in whom spontaneous resolution typically occurs once lifting of the child is less frequent.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 30 - 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 given at 3 months:

      Your Answer:

      Correct Answer: Rotavirus

      Explanation:

      At 3 months the following vaccines are given:
      Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B (2nd dose)
      Pneumococcal (13 serotypes)
      Rotavirus (2nd dose)

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
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