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Question 1
Correct
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Which of the following is NOT a typical feature of benzodiazepine toxicity:
Your Answer: Hyperventilation
Explanation:Features of benzodiazepine toxicity include: drowsiness, ataxia, dysarthria, nystagmus, occasionally respiratory depression and coma
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 2
Incorrect
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A 56-year-old female presents at the hospital with a diabetic foot ulcer that has become infected. She has a longstanding history of type 2 diabetes mellitus and diabetic polyneuropathy. She has trouble controlling her blood sugar levels, and recently, she was converted to a new insulin regimen that includes intermediate-acting insulin.Out of the following, which one is the intermediate-acting insulin?
Your Answer: Insulin detemir
Correct Answer: Isophane insulin
Explanation:Insulin is used mainly in type 1 diabetes, where the pancreas makes no insulin and can sometimes be prescribed in type 1 diabetes. There are different types of insulin categorized by their onset of action:1. Intermediate-acting insulins (isophane insulin NPH): – intermediate duration of action, designed to mimic the effect of endogenous basal insulin- starts their action in 1 to 4 hours- peaks in 4 to 8 hours – dosing is usually twice a day and helps maintain blood sugar throughout the day- Isophane insulin is a suspension of insulin with protamine2. Short-acting insulins (regular insulin)- starts the action in 30 to 40 minutes- peaks in 90 to 120 minutes- duration of action is 6 to 8 hours- taken before meals, and food is necessary within 30 minutes after its administration to avoid hypoglycaemia3. Long-acting insulins (glargine, detemir, degludec)- start action in 1 to 2 hours- plateau effect over 12 to 24 hours- Dosing is usually during the night-time after meals. Their long duration of action helps in reducing the frequency of dosing throughout the day. 4. Rapid-acting insulins (lispro, aspart, glulisine) – start their action in 5 to 15 minutes- peak in 30 minutes- The duration of action is 3 to 5 hours- generally used before meals and always used along with short-acting or long-acting insulins to control sugar levels throughout the day.
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This question is part of the following fields:
- Endocrine Pharmacology
- Pharmacology
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Question 3
Correct
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Which of the following is an action of glucagon:
Your Answer: Stimulates glycogenolysis
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.
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This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 4
Correct
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During the second and third trimesters of her pregnancy, a 36-year-old woman is given a drug to treat a medical condition. The foetus has developed hypoperfusion and the oligohydramnios sequence as a result of this.Which of the following drugs is most likely to be the cause of these side effects?
Your Answer: Ramipril
Explanation:Hypoperfusion, renal failure, and the oligohydramnios sequence are all linked to ACE inhibitor use in the second and third trimesters. The oligohydramnios sequence refers to a foetus’ or neonate’s atypical physical appearance as a result of oligohydramnios in the uterus. It’s also linked to aortic arch obstructive malformations and patent ductus arteriosus.The inhibitory effects on the renin-angiotensin-aldosterone system appear to be the cause of these defects. To avoid these risks, ACE inhibitors should be stopped before the second trimester.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 5
Correct
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A 76-year-old man presents with complaints of double vision. Upon physical examination, it was observed that he exhibits left-sided hemiplegia and left-sided loss of joint position sense, vibratory sense and discriminatory touch. In addition, he has the inability to abduct his right eye and is holding his head towards the right side. A CT scan was ordered and showed that he has suffered a right-sided stroke. Branches of which of the following arteries are most likely implicated in the case?
Your Answer: Basilar artery
Explanation:Inferior medial pontine syndrome, also known as Foville syndrome, is one of the brainstem stroke syndromes which occurs when there is infarction of the medial inferior aspect of the pons due to occlusion of the paramedian branches of the basilar artery.It is characterized by ipsilateral sixth nerve palsy, facial palsy, contralateral hemiparesis, contralateral loss of proprioception and vibration, ipsilateral ataxia, ipsilateral facial weakness, and lateral gaze paralysis and diplopia.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 6
Incorrect
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The transport of oxygen from maternal to fetal circulation is made possible by fetal haemoglobin. Which of the statements about fetal haemoglobin (HbF) is also correct?
Your Answer: It has a higher affinity for oxygen than myoglobin
Correct Answer: The oxygen dissociation curve for foetal haemoglobin is shifted to the left of that of adult haemoglobin
Explanation:Fetal haemoglobin is the most common type of haemoglobin found in the foetus during pregnancy. It transports oxygen from the maternal circulation to the fetal circulation. It can easily bind to oxygen from the maternal circulation because it has a high affinity for oxygen. From 10 to 12 weeks of pregnancy to the first six months after birth, the erythroid precursor cells produce fetal haemoglobin. In comparison to adult haemoglobin, fetal haemoglobin has two alpha and two gamma subunits, whereas adult haemoglobin has two alpha and two beta subunits in its major form. And, unlike adult haemoglobin, the oxygen dissociation curve of fetal haemoglobin is left-shifted. Myoglobin is an oxygen storage molecule with a very high affinity for oxygen. Only when the partial pressure of oxygen is exceeded does it release oxygen.
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This question is part of the following fields:
- Physiology
- Respiratory Physiology
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Question 7
Correct
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Regarding Campylobacter gastroenteritis, which of the following statements is INCORRECT:
Your Answer: Infection usually requires antibiotic treatment.
Explanation:Campylobacter jejuni is the primary human pathogen, typically causing dysentery (bloody diarrhoea illness) following ingestion of contaminated meat, especially poultry. Infection is typically self-limiting and does not require antibiotic therapy. Campylobacter gastroenteritis is associated with the immune-mediated complications of Guillain-Barre syndrome, reactive arthritis and Reiter’s syndrome.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 8
Incorrect
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Regarding airway resistance, which of the following statements is INCORRECT:
Your Answer: Airway resistance is primarily determined by the airway radius according to Poiseuille's law.
Correct Answer: In the lower respiratory tract, airway resistance is mostly determined by the smallest bronchioles.
Explanation:Airway resistance is primarily determined by the airway radius according to Poiseuille’s law, and whether the flow is laminar or turbulent. The major site of airway resistance is the medium-sized bronchi. The smallest airways would seem to offer the highest resistance, but they do not because of their branching parallel arrangement.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 9
Incorrect
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Which of the following is NOT a common clinical manifestation of sickle cell disease?
Your Answer: Hand-foot syndrome
Correct Answer: Iron deficiency
Explanation:Signs and symptoms of Sickle cell disease(SCD):Acute and chronic pain: The most common clinical manifestation of SCD is vaso-occlusive crisis; pain crises are the most distinguishing clinical feature of SCDBone pain: Often seen in long bones of extremities, primarily due to bone marrow infarctionAnaemia: Universally present, chronic, and haemolytic in natureAplastic crisis: Serious complication due to infection with parvovirus B19 (B19V)Splenic sequestration: Characterized by the onset of life-threatening anaemia with rapid enlargement of the spleen and high reticulocyte countInfection: Organisms that pose the greatest danger include encapsulated respiratory bacteria, particularly Streptococcus pneumoniae; adult infections are predominantly with gram-negative organisms, especially SalmonellaGrowth retardation, delayed sexual maturation, being underweightHand-foot syndrome: This is a dactylitis presenting as bilateral painful and swollen hands and/or feet in childrenAcute chest syndrome: Young children present with chest pain, fever, cough, tachypnoea, leucocytosis, and pulmonary infiltrates in the upper lobes; adults are usually afebrile, dyspnoeic with severe chest pain, with multilobar/lower lobe diseasePulmonary hypertension: Increasingly recognized as a serious complication of SCDAvascular necrosis of the femoral or humeral head: Due to vascular occlusionCentral nervous system (CNS) involvement: Most severe manifestation is strokeOphthalmologic involvement: Ptosis, retinal vascular changes, proliferative retinitisCardiac involvement: Dilation of both ventricles and the left atriumGastrointestinal involvement: Cholelithiasis is common in children; liver may become involvedGenitourinary involvement: Kidneys lose concentrating capacity; priapism is a well-recognized complication of SCDDermatologic involvement: Leg ulcers are a chronic painful problem
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This question is part of the following fields:
- Haematology
- Pathology
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Question 10
Correct
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A 70-year-old patient develops bacteraemia following peripheral cannulation.Which of these bacteria is the most likely cause of the infection?
Your Answer: Staphylococcus epidermidis
Explanation:The commonest implicated organisms in hospital-acquired bacteraemia following cannulation are Staphylococcus aureus and Staphylococcus epidermidis. The risk is directly proportional to the length of time in-situ. Peripheral cannula should be replaced after 48 hours.
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This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 11
Incorrect
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Hartmann's solution contains how much sodium:
Your Answer: 150 mmol/L
Correct Answer: 131 mmol/L
Explanation:Hartmann’s solution (compound sodium lactate) contains: Na+131 mmol/L, K+5 mmol/L, HCO3-29 mmol/L (as lactate), Cl-111 mmol/L, Ca2+2 mmol/L. It can be used instead of isotonic sodium chloride solution during or after surgery, or in the initial management of the injured or wounded; it may reduce the risk of hyperchloraemic acidosis.
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This question is part of the following fields:
- Fluids And Electrolytes
- Pharmacology
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Question 12
Incorrect
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The last two segments of the nephrons are the distal convoluted tubule (DCT) and collecting duct (CD).Which cell reabsorbs sodium more in the late DCT and CD?
Your Answer: Intercalated cells
Correct Answer: Principal cells
Explanation:The main Na+ reabsorbing cells in the late distal convoluted tubule and collecting duct are the principal cells. These make up the majority of the tubular cells. The exchange is driven by the Na.K.ATPase pumps on the basolateral membrane.
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This question is part of the following fields:
- Physiology
- Renal Physiology
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Question 13
Correct
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Which of the following is NOT a notifiable disease:
Your Answer: HIV
Explanation:HIV mainly infects CD4+ T helper cells. Viral replication results in progressive T-cell depletion and impaired cell-mediated immunity with subsequent secondary opportunistic infections and increased risk of malignancy. B-cell function is also reduced as a result of lack of T-cell stimulation.HIV is not a notifiable disease.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 14
Correct
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Na+ is reabsorbed via the Na+/K+/2Cl-symporter in which part of the loop of Henle?
Your 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.
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This question is part of the following fields:
- Physiology
- Renal
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Question 15
Correct
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Regarding Clostridium tetani, which of the following statements is CORRECT:
Your Answer: Infection is predominantly derived from animal faeces and soil.
Explanation:Clostridium tetaniis a Gram positive, rod shaped, obligate anaerobic bacterium.The incubation period is quoted as anywhere between 4-21 days and can occur after several months but symptoms usually occur within the first 7 days after exposure.Approximately 80% of patients develop generalised tetanus. The commonest presenting feature of generalised tetanus is trismus (lockjaw), occurring in approximately 75% of affected individuals. Other clinical features include:Facial spasms (risus sardonicus)Opisthotonus (characteristic body shape during spasms)Neck stiffnessDysphagiaCalf and pectoral muscle rigidityFeverHypertensionTachycardiaSpasms can occur frequently and last for several minutes, they can continue to occur for up to 4 weeks. Current mortality rates are between 10 and 15%.Tetanic spasms are caused by the exotoxin tetanospasmin. The effects of tetanolysin are not fully understood but it is not believed to have clinical significance.Localised tetanus is a rare form of the disease, occurring in around 1% of affected individuals. Patients have persistent contraction of muscles in the same anatomic area as the injury. It may precede generalised tetanus.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 16
Incorrect
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The extensor digitorum longus is supplied by which nerve?
Your Answer: Superficial peroneal nerve
Correct Answer: Deep peroneal nerve
Explanation:The extensor digitorum longus is innervated by the deep fibular nerve (L5, S1), a branch of the common fibular nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 17
Incorrect
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In the small intestine, there is a deep gap between each villus that leads to the crypt of Lieberkühn, a tubular intestinal gland.What is the primary function of these glands?
Your Answer: Production of an acidic intestinal juice
Correct Answer: Production of an alkaline intestinal juice
Explanation:In the small intestine, there is a deep gap between each villus that leads to the crypt of Lieberkühn, a tubular intestinal gland. These glands create an alkaline intestinal juice that is a mixture of water and mucus with a pH of 7.4-7.8. Intestinal juice is released in a volume of 1-2 litres per day in response to distention of the small intestine or the irritating effects of chyme on the intestinal mucosa.
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This question is part of the following fields:
- Gastrointestinal Physiology
- Physiology
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Question 18
Correct
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A 34-year-old man presents with loss of vision in his left eye due to an episode of optic neuritis. Upon history taking, it was noted that he has a history of multiple sclerosis. Which of the following anatomical points in the visual pathway has the lesion occurred?
Your Answer: Optic nerve
Explanation:A lesion in the optic nerve causes ipsilateral monocular visual loss.Optic neuritis is an inflammatory demyelination of the optic nerve that is highly associated with multiple sclerosis. The two most common symptoms of optic neuritis are vision loss and eye pain.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 19
Incorrect
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Identify the type of graph described below:This graph is a useful tool for evaluating the performance of diagnostic tests and more generally for evaluating the accuracy of a statistical model (e.g., logistic regression, linear discriminant analysis) that classifies subjects into 1 of 2 categories, diseased or non diseased. The closer the graph is to the upper left corner, which represents 100% sensitivity and 100% specificity, the more accurate the diagnostic test.
Your Answer: Kaplan-Meier plot
Correct Answer: ROC curve
Explanation:Receiver-operating characteristic (ROC) analysis was originally developed during World War II to analyse classification accuracy in differentiating signal from noise in radar detection. Recently, the methodology has been adapted to several clinical areas heavily dependent on screening and diagnostic tests, in particular, laboratory testing, epidemiology, radiology, and bioinformatics. ROC analysis is a useful tool for evaluating the performance of diagnostic tests and more generally for evaluating the accuracy of a statistical model (e.g., logistic regression, linear discriminant analysis) that classifies subjects into 1 of 2 categories, diseased or non diseased. Its function as a simple graphical tool for displaying the accuracy of a medical diagnostic test is one of the most well-known applications of ROC curve analysis.The closer the ROC curve is to the upper left corner, which has 100% sensitivity and 100% specificity, the higher the overall accuracy of the diagnostic test.
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This question is part of the following fields:
- Evidence Based Medicine
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Question 20
Incorrect
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An analytical cohort study is done to compare the relationship between omega 3 intake and occurrence of myocardial infarction (MI) among males aged over 65 years. The following are the data from the study:No. of subjects taking placebo: 100 menNo. of subjects taking placebo who suffered an MI: 15 menNo. of subjects taking omega 3: 100 menNo. of subjects taking omega 3 who suffered an MI: 5 menCompute for the relative risk of the study.
Your Answer: 0.15
Correct Answer: 0.33
Explanation:Relative risk (RR) is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.RR can be computed as the absolute risk of events in the treatment group (ART), divided by the absolute risk of events in the control group (ARC).RR = ART/ARCRR = (5/100) / (15/100)RR = 0.33
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This question is part of the following fields:
- Evidence Based Medicine
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Question 21
Correct
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A 57-year old man presented himself to the emergency room with persistent cough. During history taking, a record of his previous sputum sample was seen and the report stated that it tested positive for AFB (acid-fast bacilli). What is the most likely pathogen?
Your Answer: Mycobacterium tuberculosis
Explanation:M. tuberculosis is the causative agent of pulmonary tuberculosis (TB). The most commonly used diagnostic test for the diagnosis of pulmonary TB is the direct sputum smear microscopy (DSSM) wherein the presence of acid-fast bacilli (AFB) is tested. The most common method is the hot method or also known as Ziehl-Neelsen method. This is a staining method special for Mycobacteria species because they are known to be acid-fast which means that they are not easily decolorized by acid alcohol. Once the DSSM tests positive for acid-fast bacilli, this indicates possible infection with tuberculosis. The gold standard for diagnosis is still culture but Mycobacteria species are slow-growers that is why DSSM is considered the best diagnostic method. A positive AFB smear and correlation with symptoms is usually used by physicians to create a final diagnosis of pulmonary tuberculosis.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 22
Correct
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The interquartile range (IQ) is often displayed using which of the following:
Your Answer: Box and whisker plot
Explanation:A boxplot is a vertical or horizontal rectangle used to display the interquartile range, with the ends of the rectangle corresponding to the upper and lower quartiles of the data values. The box contains 50% of the data values. A line drawn through the rectangle corresponds to the median value. Whiskers, starting at the ends of the rectangle usually indicate the minimum and maximum values, therefore the entire box and whisker plot represents the range. Any outliers can be plotted independent of the box and whisker plot.
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 23
Correct
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You are about to perform a blood test on a patient suspected of having systemic lupus erythematosus. Which antibodies will indicate a positive result of systemic lupus erythematosus?
Your Answer: Anti-nuclear antibodies
Explanation:Antinuclear antibodies (ANA) are autoantibodies to the cells’ nucleus. The ANA test is the most sensitive diagnostic test for verifying the disease’s diagnosis. Other autoantibodies that may be found in SLE patients include rheumatoid factor, antiphospholipid antibodies, and antimitochondrial antibodies.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 24
Correct
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A patient presents with an acute severe asthma attack. Following a poor response to his initial salbutamol nebuliser, you administer a further nebuliser that this time also contains ipratropium bromide.After what time period would you expect the maximum effect of the ipratropium bromide to occur? Select ONE answer only.
Your Answer: 30 -60 minutes
Explanation:Ipratropium bromide is an antimuscarinic drug used in the management of acute asthma and COPD. It can provide short-term relief in chronic asthma, but short-acting β2agonists act more quickly and are preferred.The BTS guidelines recommend that nebulised ipratropium bromide (0.5 mg 4-6 hourly) can be added to β2agonist treatment for patients with acute severe or life-threatening asthma or those with a poor initial response to β2 agonist therapy.The aerosol inhalation of ipratropium can be used for short-term relief in mild chronic obstructive pulmonary disease in patients who are not already using a long-acting antimuscarinic drug (e.g. tiotropium).Its maximum effect occurs 30-60 minutes after use; its duration of action is 3-6 hours, and bronchodilation can usually be maintained with treatment three times per day.The commonest side effect of ipratropium bromide is dry mouth. It can also trigger acute closed-angle glaucoma in susceptible patients. Tremor is commonly seen with β2agonists but not with antimuscarinics. Ipratropium bromide should be used with caution in: Men with prostatic hyperplasia and bladder-outflow obstruction (worsened urinary retention has been reported in elderly men), People with chronic kidney disease (CKD) stages 3 and above (because of the risk of drug toxicity), People with angle-closure glaucoma (nebulised mist of antimuscarinic drugs can precipitate or worsen acute angle-closure glaucoma)
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This question is part of the following fields:
- Pharmacology
- Respiratory Pharmacology
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Question 25
Correct
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A 13-year-old male presents to the Emergency Department with a heavy nosebleed. His medical record shows that he was diagnosed with Haemophilia B as a child. What is the mode of inheritance of this disease?
Your Answer: X-linked recessive
Explanation:Deficiency of Factor IX causes Haemophilia B, and like the other Haemophilia’s, it has an X-linked recessive pattern of inheritance, affecting males born to carrier mothers.Haemophilia B is the second commonest form of haemophilia and is rarer than haemophilia A. Haemophilia B is similar to haemophilia A but is less severe. You can distinguish the two disorders by specific coagulation factor assays. The incidence of Haemophilia B is one-fifth of that of haemophilia A. In laboratory findings, you get prolonged APTT, normal PT and low factor IX for Haemophilia B. There is also a variation called Leyden, in which factor IX levels are below 1% until puberty, when they rise, potentially reaching as high as 40-60% of normal. This is thought to be due to the effects of testosterone at puberty.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 26
Incorrect
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A 40-year-old man with reduced urine output, nausea, and confusion also has a 150% rise of creatinine from baseline over the past 7 days. A diagnosis of acute kidney injury (AKI) is made after more tests are done.His AKI stage is?
Your Answer: Stage 3
Correct Answer: Stage 2
Explanation:This patient with a 150% rise of creatinine above baseline within 7 days has stage 2 Acute kidney injury (AKI).AKI stages are as follows:Stage 1Creatinine rise of 26 micromole/L or more within 48 hours, orCreatinine rise of 50-99% from baseline within 7 days (1.5-1.99 x baseline),orUrine output <0.5 mL/kg/hour for more than 6 hoursStage 2Creatinine rise of 100-199% from baseline within 7 days (2.0-2.99 x baseline),orUrine output <0.5 mL/kg/hour for more than 12 hoursStage 3Creatinine rise of 200% or more from baseline within 7 days (3.0 or more x baseline), orCreatinine rise to 354 micromole/L or more with acute rise of 26 micromole/L or more within 48 hours or 50% or more rise within 7 days, orUrine output <0.3 mL/kg/hour for 24 hours or anuria for 12 hours
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 27
Incorrect
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At rest, saliva is produced predominantly by which of the following:
Your Answer: Von Ebner's glands
Correct Answer: Submandibular gland
Explanation:At rest, most saliva is produced by the submandibular gland (65%). When stimulated by the autonomic nervous system, about 50% of saliva is produced by the parotid gland with only 30% produced by the submandibular gland.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 28
Correct
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When inserting a Seldinger chest drain for management of pneumothorax, the 'safe triangle' should be identified. Which of the following forms the inferior border of the 'safe triangle'?
Your Answer: 5 th intercostal space
Explanation:Care and management of the thoracostomy tubes (chest tubes) are subject to the direction and practice pattern of the responsible physician. Therefore, it is difficult to make a “one size fits all” set of instructions about the specific management recommendations for all chest tubes. It is recommended to discuss specific expectations for management with the patient’s attending physician. Facility specific Clinical Practice Guidelines (CPGs) may provide further guidance for one’s practice.Placement of the appropriately sized chest tube is performed on the affected side. The typical landmark for placement is the 4th or 5th intercostal space (nipple line for males, inframammary fold for females) at the anterior axillary line. The space above the 5th intercostal space and below the base of the axilla that is bordered posteriorly by the trapezius and anteriorly by the pectoralis muscle has recently been described as the safe triangle. Tubes are positioned anteriorly for pneumothoraces and posteriorly for fluid processes.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 29
Incorrect
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Which of the following is NOT a common side effect of antihistamines:
Your Answer: Blurred vision
Correct Answer: Tremor
Explanation:Common side effects of antihistamines may include:Anticholinergic effects (blurred vision, dry mouth, urinary retention)HeadacheGastrointestinal disturbancesPsychomotor impairment (sedation, dizziness and loss of appetite)These side effects are significantly reduced with second-generation agents.
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This question is part of the following fields:
- Pharmacology
- Respiratory
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Question 30
Correct
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Glucagon is secreted by which of the following pancreatic cell types:
Your Answer: α cells
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.
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This question is part of the following fields:
- Endocrine
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
