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  • Question 1 - Regarding nitrous oxide, which of the following statements is CORRECT: ...

    Correct

    • Regarding nitrous oxide, which of the following statements is CORRECT:

      Your Answer: Nitrous oxide may be used for maintenance of anaesthesia where its use allows reduced dosage of other agents.

      Explanation:

      For anaesthesia, nitrous oxide is commonly used in a concentration of around 50 – 66% in oxygen in association with other inhalation or intravenous agents. Nitrous oxide cannot be used as the sole anaesthetic agent due to lack of potency, but is useful as part of a combination of drugs since it allows reduction in dosage of other agents. Exposure to nitrous oxide for prolonged periods, either by continuous or by intermittent administration, may result in megaloblastic anaemia as a result of interference with the action of vitamin B12. Nitrous oxide increases cerebral blood flow and should be avoided in patients with, or at risk of, raised intracranial pressure. Nitrous oxide may be administered by any trained personnel experienced in its use.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      21.5
      Seconds
  • Question 2 - A patient suffers a lower limb fracture that causes damage to the nerve...

    Incorrect

    • A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus longus.Peroneus longus receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Tibial nerve

      Correct Answer: Superficial peroneal nerve

      Explanation:

      Peroneus brevis is innervated by the superficial peroneal nerve.Peroneus longus is innervated by the superficial peroneal nerve.Peroneus tertius is innervated by the deep peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      24.4
      Seconds
  • Question 3 - Na+ is reabsorbed via the Na+/K+/2Cl-symporter in which part of the loop of...

    Incorrect

    • Na+ is reabsorbed via the Na+/K+/2Cl-symporter in which part of the loop of Henle?

      Your Answer: Thin descending limb

      Correct Answer: Thick ascending limb

      Explanation:

      In the thick ascending limb is the part of the loop of Henle in which there is active reabsorption of Na+and Cl- ions from the tubular fluid. This occurs via the Na+/K+/2Cl-symporter on the apical membrane. This mechanism is by:1. Na+ions are transported across the basolateral membrane by Na+pumps and the Cl-ions by diffusion. 2. K+leaks back into the tubular fluid via apical ROMK K+channels which creates a positive charge. 3. This positive charge drives the reabsorption of cations (Na+, K+, Ca2+, Mg2+) through paracellular pathways. 4. Due to the thick ascending limb being impermeable to water, the tubular fluid osmolality is reduced by ion reabsorption, the interstitial fluid osmolality is increased, and an osmotic difference is created.

    • This question is part of the following fields:

      • Physiology
      • Renal
      11.5
      Seconds
  • Question 4 - Regarding macrolide antibiotics, which of the following statements is CORRECT: ...

    Correct

    • Regarding macrolide antibiotics, which of the following statements is CORRECT:

      Your Answer: Macrolides are first line for treatment of whooping cough.

      Explanation:

      A macrolide antibiotic is recommended first line for whooping cough (if onset of cough is within the previous 21 days)Prescribe clarithromycin for infants less than 1 month of age.Prescribe azithromycin or clarithromycin for children aged 1 month or older, and non-pregnant adults.Prescribe erythromycin for pregnant women.Macrolides interfere with bacterial protein synthesis and are mainly active against Gram-positive organisms. They have a similar antibacterial spectrum to penicillin and are thus a useful alternative in penicillin-allergic patients. Erythromycin is commonly associated with gastrointestinal upset.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      87.6
      Seconds
  • Question 5 - Which of the following statements is correct regarding the lymphatic system? ...

    Correct

    • Which of the following statements is correct regarding the lymphatic system?

      Your Answer: Lymphatic vessels contain both smooth muscle and unidirectional valves.

      Explanation:

      Fluid filtration out of the capillaries is usually slightly greater than fluid absorption into the capillaries. About 8 L of fluid per day is filtered by the microcirculation and returns to the circulation by the lymphatic system. Lymphatic capillaries drain into collecting lymphatics, then into larger lymphatic vessels. Both of these containing smooth muscle and unidirectional valves. From this point, lymph is propelled by smooth muscle constriction and vessel compression by body movements into afferent lymphatics. It then goes to the lymph nodes where phagocytes remove bacteria and foreign materials. It is here that most fluid is reabsorbed by capillaries, and the remainder returns to the subclavian veins via efferent lymphatics and the thoracic duct. The lymphatic system has a major role to play in the body’s immune defence and also has a very important role in the absorption and transportation of fats.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      6.6
      Seconds
  • Question 6 - A medical student is reviewing the chart of a patient who has recently...

    Correct

    • A medical student is reviewing the chart of a patient who has recently been diagnosed with leukaemia. The chief resident asks him to identify ONE feature that will most support acute leukaemia diagnosis in contrast to chronic leukaemia. Which one of the following options will he pick?

      Your Answer: The patient is a child

      Explanation:

      Acute lymphocytic leukaemia (ALL) is more common in children than chronic leukaemias, which generally occur in adults. Bone marrow failure occurs early on in the course of the disease in acute leukaemias, and there is the massive proliferation of undifferentiated cells with functioning cells being crowded out. Hepatosplenomegaly occurs in both acute and chronic forms of leukaemia and is not a differentiating feature.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      25
      Seconds
  • Question 7 - A 28-year-old asthmatic patient is seen in the Emergency Department following an acute...

    Correct

    • A 28-year-old asthmatic patient is seen in the Emergency Department following an acute exacerbation. His symptoms start to improve when your consultant gives him a high dose of IV aminophylline.Which of the following is correct mechanism of action of aminophylline ?

      Your Answer: Inhibition of phosphodiesterase

      Explanation:

      Aminophylline has the following properties:Phosphodiesterase inhibitor that increases intracellular cAMP and relaxes smooth muscle in the bronchial airways and pulmonary blood vessels.Mast cell stabilization is achieved by using a non-selective adenosine receptor antagonist.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      31.1
      Seconds
  • Question 8 - C5 - C9 deficiency increases susceptibility to infection with which of the following:...

    Incorrect

    • C5 - C9 deficiency increases susceptibility to infection with which of the following:

      Your Answer: Encapsulated bacteria

      Correct Answer: Neisseria spp.

      Explanation:

      If the complement sequence is completed, an active phospholipase (the membrane attack complex, MAC) is produced, which punches holes in the cell membrane and causes cell lysis. Because the MAC appears to be the sole means to destroy the Neisseria family of bacteria, C5 – C9 deficiency increases susceptibility to Neisseria infections.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      7.5
      Seconds
  • Question 9 - Injury to which nerve can lead to weakness or paralysis of the brachialis...

    Incorrect

    • Injury to which nerve can lead to weakness or paralysis of the brachialis muscle?

      Your Answer: The radial nerve

      Correct Answer: The musculocutaneous nerve

      Explanation:

      The brachialis muscle is a prime flexor of the forearm at the elbow joint. It is fusiform in shape and located in the anterior (flexor) compartment of the arm, deep to the biceps brachii. The brachialis is a broad muscle, with its broadest part located in the middle rather than at either of its extremities. It is sometimes divided into two parts, and may fuse with the fibres of the biceps brachii, coracobrachialis, or pronator teres muscles. It also functions to form part of the floor of the cubital fossa.The brachialis is primarily supplied by the musculocutaneous nerve (C5, C6). In addition, a small lateral portion of the muscle is innervated by the radial nerve (C7).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.8
      Seconds
  • Question 10 - Which of the following nerves supplies innervation to the extensor hallucis longus? ...

    Incorrect

    • Which of the following nerves supplies innervation to the extensor hallucis longus?

      Your Answer: Superficial peroneal nerve

      Correct Answer: Deep peroneal nerve

      Explanation:

      Extensor hallucis longus is innervated by the deep fibular nerve (root value L5 and S1).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      10.9
      Seconds
  • Question 11 - All of the following statements are correct regarding penicillin antibiotics except: ...

    Correct

    • All of the following statements are correct regarding penicillin antibiotics except:

      Your Answer: Penicillins are of no use in meningitis as they are unable to penetrate into the cerebrospinal fluid.

      Explanation:

      Penicillin penetration into the cerebrospinal fluid is generally poor. However, when the meninges are inflamed, as in meningitis, penetration of penicillin is increased. Benzylpenicillin should be given before transfer to hospital if meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) is suspected, once this does not delay transfer. Benzylpenicillin is no longer the drug of first choice for pneumococcal meningitis.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      79.3
      Seconds
  • Question 12 - Surface area of the absorptive surface in the small intestine is increased by...

    Incorrect

    • Surface area of the absorptive surface in the small intestine is increased by all but which of the following:

      Your Answer: Brush border

      Correct Answer: Teniae coli

      Explanation:

      Factors increasing the surface area include:The small intestine is very long – about 5 m in length.The inner wall of the small intestine is covered by numerous folds of mucous membrane called plicae circulares.The lining of the small intestine is folded into many finger-like projections called villi.The surface of the villi is covered with a layer of epithelial cells which, in turn, have many small projections called microvilli that project towards the lumen of the intestine (forming the brush border).

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      7.5
      Seconds
  • Question 13 - Which of the following is NOT a typical cerebellar sign: ...

    Correct

    • Which of the following is NOT a typical cerebellar sign:

      Your Answer: Hypertonia

      Explanation:

      Hypotonia means decreased muscle tone. It can be a condition on its own, called benign congenital hypotonia, or it can be indicative of another problem where there is progressive loss of muscle tone, such as muscular dystrophy or cerebral palsy. It is usually detected during infancy. Hypotonia is characteristic of cerebellar dysfunction.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      5.1
      Seconds
  • Question 14 - What proportion of peripheral blood leukocytes are monocytes? ...

    Correct

    • What proportion of peripheral blood leukocytes are monocytes?

      Your Answer: 5 - 10%

      Explanation:

      Monocytes account for around 5 to 10% of peripheral white cells. Monocytes in peripheral blood are generally bigger than other leukocytes and feature a large central oval or indented nucleus with clumped chromatin. The abundant cytoplasm staining blue and containing numerous fine vacuoles gives the appearance of ground glass. Cytoplasmic granules are another type of granule. Monocytes evolve from the granulocyte-macrophage progenitor to become monoblasts, promonocytes, monocytes, and tissue macrophages (in increasing order of maturity). Monocytes only stay in the bone marrow for a short time before exiting to circulate in the bloodstream for 20-40 hours before becoming macrophages.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      5.5
      Seconds
  • Question 15 - A patient is referred for lung function tests on account of a history...

    Correct

    • A patient is referred for lung function tests on account of a history of breathlessness and cough.Which statement about lung volumes is correct?

      Your Answer: The tidal volume is the volume of air drawn in and out of the lungs during normal breathing

      Explanation:

      The tidal volume(TV) is the amount of air that moves in and out of the lungs with each respiratory cycle. In a healthy male, the usual volume is 0.5 L (,7 ml/kg body mass).The vital capacity(VC) is the maximum amount of air that can be exhaled following maximal inspiration. The usual volume in a healthy male is 4.5 L.The residual volume(RV) is the amount of air remaining in the lungs after maximum expiration. The usual volume in a healthy male is 1.0 L.The inspiratory reserve volume(IRV) is the maximum amount of air that can be breathed in forcibly after normal inspiration. The usual volume in a healthy male is 3.0 L.The expiratory reserve volume(ERV) is the volume of air that can be breathed out forcibly after normal expiration. The usual volume in a healthy male is 1.0 L.Total lung capacity(TLC) is the volume of air the lungs can accommodate. TLC = RV+VC. The usual volume in a healthy male is 5.5 L.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      94.3
      Seconds
  • Question 16 - A 71-year-old woman is treated with co-amoxiclav for a chest infection but she...

    Incorrect

    • A 71-year-old woman is treated with co-amoxiclav for a chest infection but she returns 1 week later. Her chest infection has resolved but she developed a profuse, offensive smelling diarrhoea and abdominal cramps. You suspect Clostridium difficile associated diarrhoea (CDAD).ONE of these statements is true concerning this diagnosis.

      Your Answer: Clostridium difficile spores are destroyed by alcohol hand gel

      Correct Answer: The gold standard for the diagnosis of Clostridium difficile colitis is cytotoxin assay

      Explanation:

      Clostridium difficile, a Gram-positive, anaerobic, spore forming bacteria is present in the gut of approximately 3% of healthy adults (2012 UK HPA estimates). Following use of broad spectrum antibiotics, which alter normal gut flora, Clostridium difficile associated diarrhoea (CDAD) occurs.Alcohol hand gel is not effective against Clostridium Difficile spores. Hand washing with soap and water is very essential for healthcare workers who come in contact with it.Currently, the gold standard for the diagnosis of Clostridium difficile colitis is cytotoxin assay. Stool culture to detect Clostridium difficile is not specific for pathogenic strains, is expensive and therefore not specific for a diagnosis of CDAD

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      34.9
      Seconds
  • Question 17 - The most important nerves for inversion of the foot are: ...

    Incorrect

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

      Your Answer: Tibial and superficial fibular nerve

      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
      10.3
      Seconds
  • Question 18 - Pancreatic acinar digestive enzyme secretion is mainly stimulated by which of the following...

    Incorrect

    • Pancreatic acinar digestive enzyme secretion is mainly stimulated by which of the following hormones:

      Your Answer: Secretin

      Correct Answer: Cholecystokinin

      Explanation:

      Exocrine pancreatic secretion is controlled by:Parasympathetic stimulation which enhances secretion of both the enzyme and aqueous componentsSympathetic stimulation which inhibits pancreatic secretionSecretin which stimulates secretion of the alkaline-rich fluid from ductal cellsCholecystokinin which stimulates secretion of the enzyme-rich fluid from acinar cellsSomatostatin which inhibits secretion from both acinar and ductal cellsGastrin which stimulates pancreatic acinar cells to secrete digestive enzymes

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      15.2
      Seconds
  • Question 19 - 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: Vancomycin and metronidazole

      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 valvesCongenital heart defectsPrior history of endocarditisRheumatic feverIllicit intravenous drug useIn the presentation of endocarditis, the following triad is often quoted:Persistent feverEmbolic phenomenaNew or changing murmurFlucloxacillin 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
      59.2
      Seconds
  • Question 20 - Capillaries are designed with a small diffusion distance for nutrition and gaseous exchange...

    Correct

    • Capillaries are designed with a small diffusion distance for nutrition and gaseous exchange with the tissues they serve. Capillaries come in a variety of shapes and sizes, each with its own function in transcapillary exchange.Which of the following types of capillaries is the least permeable in the human body?

      Your Answer: Continuous capillaries

      Explanation:

      Capillaries are designed with a small diffusion distance for nutrition and gaseous exchange with the tissues they serve. Because oxygen and carbon dioxide are both highly soluble in lipids (lipophilic), they can easily diffuse along a concentration gradient across the endothelial lipid bilayer membrane. In contrast, glucose, electrolytes, and other polar, charged molecules are lipid-insoluble (hydrophilic). These chemicals are unable to pass through the lipid bilayer membrane directly and must instead travel through gaps between endothelial cells.Capillaries are divided into three types: continuous, fenestrated, and sinusoidal. Each of these capillary types contains different sized gaps between the endothelial cells that operate as a filter, limiting which molecules and structures can pass through.The permeability of capillaries is affected by the wall continuity, which varies depending on the capillary type.Skeletal muscle, myocardium, skin, lungs, and connective tissue all have continuous capillaries. These capillaries are the least permeable. They have a basement membrane and a continuous layer of endothelium. The presence of intercellular spaces allows water and hydrophilic molecules to pass across. Tight connections between the cells and the glycocalyx inhibit passage via these gaps, making diffusion 1000-10,000 times slower than for lipophilic compounds. The diffusion of molecules larger than 10,000 Da, such as plasma proteins, is likewise prevented by this narrow pore system. These big substances can pass through the capillary wall, but only very slowly, because endothelial cells have enormous holes.The kidneys, gut, and exocrine and endocrine glands all have fenestrated capillaries. These are specialized capillaries that allow fluid to be filtered quickly. Water, nutrients, and hormones can pass via windows or fenestrae in their endothelium, which are connected by a thin porous membrane. They are ten times more permeable than continuous capillaries due to the presence of these fenestrae. Fenestrated capillaries have a healthy basement membrane.The spleen, liver, and bone marrow all have sinusoidal capillaries, also known as discontinuous capillaries. Their endothelium has huge gaps of >100 nm, and their basement membrane is inadequate. They are highly permeable as a result, allowing red blood cells to travel freely.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      14.5
      Seconds
  • Question 21 - A 69-year-old man with a history of chronic anaemia is transfused. He takes...

    Correct

    • A 69-year-old man with a history of chronic anaemia is transfused. He takes bisoprolol and furosemide for his cardiac failure, and his most recent BNP was 123 pmol/l. He developed shortness of breath and his pre-existing peripheral oedema became worse 5 hours after transfusion was commenced. His BP rises to 170/105 mmHg and a repeat measurement of his BNP is 192 pmol/l.What is the most likely transfusion reaction to have occurred?

      Your Answer: TACO

      Explanation:

      Transfusion-associated circulatory overload (TACO) presents as acute or worsening respiratory distress within 6 hours of transfusion of a large volume of blood. It is common in patients with diminished cardiac reserve or chronic anaemia. Elderly patients, infants and severely anaemic patients are particularly susceptible. Typical clinical features of TACO include: Acute respiratory distress, Tachycardia, Hypertension, Acute/worsening pulmonary oedema on chest X-ray. The BNP is usually raised to at least 1.5 times the pre-transfusion baseline.Febrile transfusion reaction presents with a 1 degree rise in temperature from baseline during transfusion. Patient may have chills and malaise. It is the most common transfusion reaction (1 in 8 transfusions) and is usually caused by cytokines released from leukocytes in transfused red cell or platelet components. TRALI (Transfusion Related Acute Lung Injury) is a clinical syndrome with abrupt onset of non-cardiogenic pulmonary oedema within 6 hours of transfusion not explained by another risk factor. Associated with the presence of antibodies in the donor blood to recipient leukocyte antigens. patients present with dyspnoea, hypertension, hypotension, acute leukopenia. Graft versus host disease(GVHD) is an immune mediated condition that arises from a complex interaction between donor and recipients adaptive immunity. It presents as dermatitis, hepatitis and enteritis developing within 100 days after stem cell or bone marrow transplant.Acute haemolytic reaction aka immediate haemolytic transfusion reaction presents with fever, chills, pain at transfusion site, nausea, vomiting, dark urine and feeling of ‘impending doom’. Often, it occurs due to ABO incompatibility.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      30.2
      Seconds
  • Question 22 - In a VF arrest, a 6-year-old child is brought to your Emergency Department...

    Correct

    • In a VF arrest, a 6-year-old child is brought to your Emergency Department resuscitation area. He weighs 16 kilogrammes. He's had three DC shocks, but he's still in VF and doesn't have an output.What amiodarone dose should he get now, according to the most recent APLS guidelines?

      Your Answer: 80 mg

      Explanation:

      In a shockable (Vf/pVT) paediatric cardiac arrest, amiodarone should be administered after the third and fifth shocks. The dose is 5 mg/kg (maximum 300 mg) and should be administered over a three-minute period. If at all possible, administration via a central line is recommended.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      37.3
      Seconds
  • Question 23 - Regarding apoptosis, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer: Apoptosis is mediated by activation of a caspase cascade.

      Correct Answer: Apoptosis leads to cell swelling and eventual cell lysis.

      Explanation:

      Apoptosis is a controlled form of cell death in which no cellular contents are released from the dying cell, and thus no inflammatory reaction is seen. Apoptosis may occur physiologically or pathologically. Apoptosis may be induced in two main ways: by the engagement of surface death receptors e.g. TNF-alpha (extrinsic pathway) or through cellular injury (intrinsic pathway). The end result is the activation of proteases enzymes called caspases which dismantle the cell cytoplasm and nucleus. Apoptotic cells shrink down and fragment into apoptotic bodies, each of which retains an intact cell membrane; apoptotic bodies are then targeted or rapid removal by adjacent cells. Disordered apoptosis is thought to be central to a number of important disease processes, particularly carcinogenesis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      20.5
      Seconds
  • Question 24 - An elderly female with a diagnosed psychiatric illness was prescribed prochlorperazine for her...

    Correct

    • 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: 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
      32.5
      Seconds
  • Question 25 - Which of the following best describes the positive predictive value of a diagnostic test:...

    Incorrect

    • Which of the following best describes the positive predictive value of a diagnostic test:

      Your Answer: The ratio of the chance of a positive result if the patient has the disease to the chance of a positive result if they do not have the disease

      Correct Answer: The proportion of individuals with a positive test result who have the disease

      Explanation:

      Positive predictive value (PPV) is the proportion of individuals with a positive test result who actually have the disease.PPV = a/(a+b)

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      488.2
      Seconds
  • Question 26 - What is the mechanism of action of cetirizine: ...

    Incorrect

    • What is the mechanism of action of cetirizine:

      Your Answer: H2-receptor antagonist

      Correct Answer: H1-receptor antagonist

      Explanation:

      Cetirizine is a competitive inhibitor at the H1-receptor (an antihistamine).

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      6.1
      Seconds
  • Question 27 - Alpha cells of the endocrine pancreas produce which of the following hormones: ...

    Correct

    • Alpha cells of the endocrine pancreas produce which of the following hormones:

      Your Answer: Glucagon

      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:GlycogenolysisGluconeogenesisLipolysis in adipose tissueThe secretion of glucagon is also stimulated by:AdrenalineCholecystokininArginineAlanineAcetylcholineThe secretion of glucagon is inhibited by:InsulinSomatostatinIncreased free fatty acidsIncreased urea productionGlycolysis 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
      9.9
      Seconds
  • Question 28 - Regarding flucloxacillin, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: It is primarily used in infections caused by Streptococci.

      Correct Answer: It is resistant to bacterial beta-lactamases.

      Explanation:

      Flucloxacillin is unique in that it is beta-lactamase stable and it can be used in infections caused by beta-lactamase producing staphylococci e.g. S. aureus. It is acid-stable and can therefore be given by mouth as well as by injection. It is used first line for treatment of widespread impetigo infection, cellulitis, mastitis, osteomyelitis, septic arthritis, severe erysipelas, severe/spreading otitis externa and infective endocarditis caused by staphylococci. The most common adverse effects of flucloxacillin include nausea, vomiting, skin rash, and diarrhoea. Cholestatic jaundice and hepatitis may occur very rarely, up to two months after treatment with flucloxacillin has been stopped. Administration for more than 2 weeks and increasing age are risk factors. First line treatment of animal and human bites is co-amoxiclav.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      24
      Seconds
  • Question 29 - Regarding antacids, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Antacids are best taken regularly each morning for maximum symptom control.

      Correct Answer: Antacids are contraindicated in hypophosphataemia.

      Explanation:

      Antacids are contraindicated in hypophosphataemia. Liquid preparations are more effective than tablet preparations. Magnesium-containing antacids tend to be laxative whereas aluminium-containing antacids tend to be constipating. Antacids are best taken when symptoms occur or are expected, usually between meals and at bedtime. Antacids should preferably not be taken at the same time as other drugs since they may impair absorption.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      33.2
      Seconds
  • Question 30 - You suspect that your patient with polycystic kidney disease has developed a berry...

    Incorrect

    • You suspect that your patient with polycystic kidney disease has developed a berry aneurysm as a complication of his disease. The patient complains of a sudden, severe headache. You are guessing subarachnoid haemorrhage secondary to a ruptured berry aneurysm as the cause of his severe headaches. What is the most likely location of his aneurysm?

      Your Answer: Posterior communicating artery

      Correct Answer: Anterior communicating artery

      Explanation:

      One of the complications that polycystic kidney disease may cause is the development of a brain aneurysm. A berry aneurysm is the most common type of brain aneurysm. The Circle of Willis, where the major blood vessels meet at the base of the brain, is where it usually appears. The most common junctions of the Circle of Willis where an aneurysm may occur include the anterior communicating artery (35%), internal carotid artery (30%), the posterior communicating artery and the middle cerebral artery (22%), and finally, the posterior circulation sites, most commonly the basilar artery tip.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      9.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anaesthesia (1/1) 100%
Pharmacology (6/9) 67%
Anatomy (1/6) 17%
Lower Limb (0/3) 0%
Physiology (4/7) 57%
Renal (0/1) 0%
Infections (2/3) 67%
Cardiovascular (1/1) 100%
Haematology (2/2) 100%
Pathology (3/5) 60%
Respiratory Pharmacology (1/1) 100%
Immune Responses (1/2) 50%
Upper Limb (0/1) 0%
Gastrointestinal (0/3) 0%
Central Nervous System (1/2) 50%
Respiratory Physiology (1/1) 100%
Microbiology (0/2) 0%
Specific Pathogen Groups (0/2) 0%
Cardiovascular Physiology (1/1) 100%
Cardiovascular Pharmacology (1/1) 100%
Inflammatory Responses (0/1) 0%
CNS Pharmacology (1/1) 100%
Evidence Based Medicine (0/1) 0%
Statistics (0/1) 0%
Respiratory (0/1) 0%
Endocrine (1/1) 100%
Passmed