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  • Question 1 - A 40-year-old male presents to your clinic complaining of a cough with bloody...

    Incorrect

    • A 40-year-old male presents to your clinic complaining of a cough with bloody sputum for the past three months. He has also had fever, night sweats, and has noticed some weight loss over the past three months.Which ONE of the following statements regarding this disease is correct?

      Your Answer: A Ghon focus typically appears at the apex of a lung

      Correct Answer: It can be diagnosed using the Ziehl-Neelson stain

      Explanation:

      Tuberculosis is an infection caused by the microorganism Mycobacterium tuberculosis. TB can affect any organ system in the body, but it most commonly affects the lungs, followed by the lymph nodes. Option Tuberculosis is spread by the faecal-oral route: It is spread by inhalation of droplet nuclei. There are different methods to diagnose a tuberculosis infection. 1) Direct Microscopy: The organisms are visualised using Ziehl-Neelsen or Auramine staining. This is the quickest method to establish a diagnosis and start treatment.2) Culture: M. tuberculosis can be grown on Lowenstein-Jensen or Ogawa mediums, but it can take up to 8 weeks; therefore, ZN staining is also performed to start treatment immediately. Option There are several types of vaccine currently available: The BCG vaccine is the only vaccine approved to prevent TB and is administered at birth. Option Miliary tuberculosis refers to tuberculosis that affects the spine: Miliary tuberculosis refers to a tuberculosis infection disseminated throughout the body’s organ systems via the blood or lymphatics. Pott’s disease is extrapulmonary TB that affects the spine. It usually affects the lower thoracic and upper lumbar regions.Option A Ghon focus typically appears at the apex of a lung: The Ghon focus is a primary sign of TB that forms in the lung of previously unaffected patients. It typically occurs in the mid or lower zones of the lung.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      17.1
      Seconds
  • Question 2 - A patient suffers from an injury and as a consequence, the nerve that...

    Correct

    • A patient suffers from an injury and as a consequence, the nerve that was damaged innervates the obturator internus muscle.In which of the following nerves is the obturator internus muscle innervated by?

      Your Answer: Nerve to obturator internus

      Explanation:

      The obturator internus is innervated by the obturator internus nerve (L5–S2), a branch of sacral plexus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.2
      Seconds
  • Question 3 - A 72 year old man is brought to ED by ambulance with sudden...

    Correct

    • A 72 year old man is brought to ED by ambulance with sudden onset chest pain, palpitations and shortness of breath. His HR is 160 bpm and BP 90/65. ECG demonstrates new-onset fast atrial fibrillation. Which of the following is the first-line treatment option in this case:

      Your Answer: Synchronised DC cardioversion

      Explanation:

      All patients with adverse features suggesting life-threatening haemodynamic instability (shock, syncope, heart failure, myocardial ischaemia) caused by new onset atrial fibrillation should undergo emergency electrical cardioversion with synchronised DC shock without delaying to achieve anticoagulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      7.4
      Seconds
  • Question 4 - In the ventricular myocyte action potential, depolarisation occurs through the opening of: ...

    Incorrect

    • In the ventricular myocyte action potential, depolarisation occurs through the opening of:

      Your Answer: Voltage-gated Ca 2+ channels

      Correct Answer: Voltage-gated Na + channels

      Explanation:

      An action potential (AP) is initiated when the myocyte is depolarised to a threshold potential of about -65 mV, as a result of transmission from an adjacent myocyte via gap junctions. Fast voltage-gated Na+channels are activated and a Na+influx depolarises the membrane rapidly to about +30 mV. This initial depolarisation is similar to that in nerve and skeletal muscle, and assists the transmission to the next myocyte.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      7.1
      Seconds
  • Question 5 - The results from the study investigating the accuracy of a new diagnostic test can be...

    Correct

    • The results from the study investigating the accuracy of a new diagnostic test can be displayed in the following format. How is the positive predictive value calculated:Those with diseaseThose without diseaseTotalTest positiveaba+bTest negativecdc+dTotala+cb+dn=a+b+c+d

      Your Answer: a/(a+b)

      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
      18.5
      Seconds
  • Question 6 - Which of the following statements is correct regarding homeostasis? ...

    Incorrect

    • Which of the following statements is correct regarding homeostasis?

      Your Answer: Negative feedback systems prevent oscillations in the variable they control.

      Correct Answer: In negative feedback mechanisms, effectors always act to move the variable in the opposite direction to the change that was originally detected.

      Explanation:

      The vast majority of systems within the body work by negative feedback mechanisms. This negative feedback refers to the way that effectors act to move the variable in the opposite direction to the change that was originally detected. Because there is an inherent time delay between detecting a change in a variable and effecting a response, the negative feedback mechanisms cause oscillations in the variable they control. There is a narrow range of values within which a normal physiological function occurs and this is called the ‘set point’. The release of oxytocin in childbirth is an example of positive feedback.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      24.2
      Seconds
  • Question 7 - Which of the following nerves is most likely associated with an anterior shoulder...

    Correct

    • Which of the following nerves is most likely associated with an anterior shoulder dislocation?

      Your Answer: Axillary nerve

      Explanation:

      In an anterior dislocation, the arm is an abducted and externally rotated position. In the externally rotated position, the posterosuperior aspect of the humeral head abuts and drives through the anteroinferior aspect of the glenoid rim. This can damage the humeral head, glenoid labrum, or both. An associated humeral head compression fracture is described as a Hill Sach’s lesion. If large enough, it can lead to locked dislocations that may require open reduction. The glenoid labrum is a fibrocartilaginous structure that rings the circumference of the glenoid fossa. Bankart lesions are injuries to the anteroinferior glenoid labrum complex and the most common capsulolabral injury. A bony Bankart lesion refers to an associated fracture of the glenoid rim. These capsulolabral lesions are risk factors for recurrent dislocation.Axillary nerve injury is identified in about 42% of acute anterior shoulder dislocations. Nerve transection is rare, and traction injuries are more common. Arterial injury has also been described. The subclavian artery becomes the axillary artery after passing the first rib. The distal portion of the axillary artery is anatomically fixed and, therefore, susceptible to injury in anterior dislocations. Ischemic injury, including pseudoaneurysm and arterial laceration, is rare but carries marked morbidity if not quickly identified.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.2
      Seconds
  • Question 8 - Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic...

    Incorrect

    • Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels. The phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.A phenylalkylamine calcium-channel blocker is, for example, which of the following?

      Your Answer: Nifedipine

      Correct Answer: Verapamil

      Explanation:

      Calcium-channel blockers, also known as calcium antagonists, stop calcium from entering cells through the L-type calcium channel. This causes vascular smooth muscle in vessel walls to relax, resulting in a decrease in peripheral vascular resistance. They can be used for a variety of things, including:HypertensionAnginaAtrial fibrillationMigraineCalcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels.Dihydropyridines have a high vascular selectivity and lower systemic vascular resistance and blood pressure. As a result, they’re frequently used to treat hypertension. Modified release formulations are also used to treat angina, but their powerful systemic vasodilator and pressure-lowering effects can cause reflex cardiac stimulation, resulting in increased inotropy and tachycardia, which can counteract the beneficial effects of reduced afterload on myocardial oxygen demand.The suffix -dpine distinguishes dihydropyridines from other pyridines. Examples of dihydropyridines that are commonly prescribed include:AmlodipineFelodipineNifedipineNimodipineThe phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.Phenylalkylamines are less effective as systemic vasodilators because they are relatively selective for the myocardium. This group of drugs lowers myocardial oxygen demand and reverses coronary vasospasm, making them useful in the treatment of angina. They are also occasionally used to treat arrhythmias. A phenylalkylamine calcium-channel blocker like verapamil is an example.In terms of selectivity for vascular calcium channels, benzothiazepines fall somewhere between dihydropyridines and phenylalkylamines. They can lower arterial pressure without producing the same level of reflex cardiac stimulation as dihydropyridines because they have both cardiac depressant and vasodilator effects. Diltiazem is the only benzothiazepine currently in clinical use.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      212.7
      Seconds
  • Question 9 - A 66-year-old female who is a known case of atrial fibrillation comes to...

    Correct

    • A 66-year-old female who is a known case of atrial fibrillation comes to the Emergency Department with the complaint of fever and vomiting for the past two days. When her medical chart is reviewed, you see that she takes Warfarin for her arrhythmia. Which ONE of the following medications cannot be prescribed to this patient?

      Your Answer: Ibuprofen

      Explanation:

      Like other non-steroidal anti-inflammatory drugs, Ibuprofen cannot be given with Warfarin as it would increase the bleeding risk of this patient.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      8.6
      Seconds
  • Question 10 - Which of the following antibiotics may be used for malaria prophylaxis: ...

    Incorrect

    • Which of the following antibiotics may be used for malaria prophylaxis:

      Your Answer: Rifampicin

      Correct Answer: Doxycycline

      Explanation:

      Doxycycline may be used for malaria prophylaxis and as an adjunct to quinine in the treatment of Plasmodium falciparum malaria.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      5.8
      Seconds
  • Question 11 - Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT...

    Correct

    • Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT for:

      Your Answer: Hepatitis A

      Explanation:

      Disease specific immunoglobulins are available for:hepatitis Brabiestetanusvaricella-zosterNormal immunoglobulin can be used to confer protection against hepatitis A.

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      24.8
      Seconds
  • Question 12 - A migrant from Eastern Europe needs to have screening performed for tuberculosis (TB)...

    Correct

    • A migrant from Eastern Europe needs to have screening performed for tuberculosis (TB) because he is a high-risk patient.Which statement concerning TB screening in the UK is true?

      Your Answer: Vaccination with the BCG can result in a false positive test

      Explanation:

      Vaccination with the BCG can result in a false positive test.The Mantoux test replaced the Heaf test as the TB screening test in the UK in 2005.The ‘Sterneedle’ gun is used to inject 100,000 units/ml of tuberculin purified protein derivative into the skin for the Heaf testThe Mantoux test involves the injection of 5 Tuberculin units (0.1mL) intradermally and the result read 2-3 days later. The interferon gamma release assay (IGRA) should NOT be used for neonates

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      254.7
      Seconds
  • Question 13 - Which of the following statements accurately describes the extensor indicis muscle? ...

    Incorrect

    • Which of the following statements accurately describes the extensor indicis muscle?

      Your Answer: It cannot be moved independently from the other digits

      Correct Answer: It lacks the juncturae tendinum

      Explanation:

      Extensor indicis is a narrow, elongated muscle found in the posterior compartment of the forearm. It belongs to the deep extensors of the forearm, together with supinator, abductor pollicis longus, extensor pollicis longus, and extensor pollicis brevis muscles. It lacks the juncturae tendinum, which connects the extensor digitorum on the dorsal aspect of the hand.Extensor indicis can be palpated by applying deep pressure over the lower part of the ulna while the index finger is extended. The main function of extensor indicis involves the extension of the index finger at the metacarpophalangeal and interphalangeal joints. As the index finger is one of the few fingers that have their own separate extensor muscle, it is able to extend independently from other fingers. Additionally, extensor indicis muscle produces a weak extension of the wrist.Extensor indicis receives its nervous supply from posterior interosseous nerve, a branch of the radial nerve derived from spinal roots C7 and C8. The skin overlying the muscle is supplied by the same nerve, with fibres that stem from the spinal roots C6 and C7.The superficial surface of the extensor indicis receives arterial blood supply from posterior interosseous branch of the ulnar artery, whereas its deep surface receives blood from perforating branches of the anterior interosseous artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      79.7
      Seconds
  • Question 14 - Caseous necrosis is typically seen in which of the following: ...

    Correct

    • Caseous necrosis is typically seen in which of the following:

      Your Answer: Tuberculosis

      Explanation:

      Caseous necrosis is most commonly seen in tuberculosis. Histologically, the complete loss of normal tissue architecture is replaced by amorphous, granular and eosinophilic tissue with a variable amount of fat and an appearance reminiscent of cottage cheese.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      6.8
      Seconds
  • Question 15 - One of your patients is in resuscitation and is suffering from kidney failure....

    Incorrect

    • One of your patients is in resuscitation and is suffering from kidney failure. The intensive care outreach team arrives to assess them and determines that a dopamine infusion is necessary.Dopamine primarily acts on which of the following receptors at low doses?

      Your Answer: Alpha-2 receptors

      Correct Answer: Dopamine receptors

      Explanation:

      Dopamine is a catecholamine that occurs naturally and is used to treat low cardiac output, septic shock, and renal failure. It is both adrenaline and noradrenaline’s immediate precursor.Dopamine acts on D1 and D2 dopamine receptors in the renal, mesenteric, and coronary beds at low doses (1-5 g/kg/min). Dopamine causes a significant decrease in renal vascular resistance and an increase in renal blood flow at these doses. Within this dose range, it is also involved in central modulation of behaviour and movement.Dopamine stimulates beta- and alpha-adrenergic receptors directly and indirectly at higher doses. Beta-stimulation predominates at a rate of 5-10 g/kg/min, resulting in a positive inotropic effect that increases cardiac output and coronary blood flow. Alpha-stimulation predominates at infusion rates greater than 15 g/kg/min, resulting in peripheral vasoconstriction and an increase in venous return and systolic blood pressure.Below is a summary of the mechanisms and effects of various inotropic agents:InotropeMechanismEffectsAdrenaline (epinephrine)Beta-1 and -2 agonist at increasing doses;Alpha-agonist at high dosesIncreased cardiac output;Vasoconstriction at higher dosesNoradrenaline (norepinephrine)Mainly alpha-agonist;Beta-1 and -2 agonist at increasing dosesVasoconstriction;Some increased cardiac outputDopamineDopamine agonist at low doses;Beta-1 and -2 agonist at increasing doses;Alpha-agonist at high dosesIncreased cardiac output;Vasoconstriction at higher dosesDobutamineMainly beta-1 agonistIncreased cardiac output

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      21.2
      Seconds
  • Question 16 - A patient presents to your Emergency Department with a laceration on their buttocks...

    Correct

    • A patient presents to your Emergency Department with a laceration on their buttocks requiring closure with sutures.What stage of wound healing is the first to reach completion?

      Your Answer: Haemostasis

      Explanation:

      The stages of wound healing are: haemostasis, inflammatory, proliferative and remodelling (maturation) phases in that order. The first stage in the healing process of a laceration is haemostasis. Haemostasis is the process of the wound being closed by clotting. The inflammatory phase occurs just after and up to 48 hours after injury– Blood vessels dilate to allow white blood cells, antibodies, growth factors, enzymes and nutrients to reach the wounded area leading to the characteristic signs of inflammation seen. Epithelialisation and angiogenesis are not phases of wound healing but occur during the proliferative phase. This ia after haemolysis and inflammation phases have occurred.The maturation phase is the final phase and occurs when the wound has closed. It involves remodelling of collagen from type III to type I. Apoptosis remove unwanted cells, cellular activity reduces and the number of blood vessels in the wounded area regresses and decreases. This can continues for up to 1 year after injury.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      12.1
      Seconds
  • Question 17 - Which of the following is NOT a typical effect caused by adrenaline: ...

    Correct

    • Which of the following is NOT a typical effect caused by adrenaline:

      Your Answer: Bronchoconstriction

      Explanation:

      Actions of adrenaline:Cardiovascular system- Increased rate and force of cardiac contraction- Vasoconstriction of vessels in skin, mucous membranes and splanchnic bed- Vasodilation of skeletal muscle vessels- Increased cardiac output and blood pressureRespiratory system- Bronchodilation- Increased ventilation rateGastrointestinal system- Smooth muscle relaxation- Contraction of sphincters- Metabolism- Decreased insulin release- Increased glucagon release- Increased thermogenesis- Increased glycolysis- Increased lipolysisEye- Pupillary dilation

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      9.8
      Seconds
  • Question 18 - A patient is diagnosed as having a glucagonoma. Her blood serum glucagon concentration...

    Correct

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

      Your Answer: Alpha-cells in the pancreas

      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
      • Physiology
      106
      Seconds
  • Question 19 - Myocardial contractility is best correlated with the intracellular concentration of: ...

    Correct

    • Myocardial contractility is best correlated with the intracellular concentration of:

      Your Answer: Ca2+

      Explanation:

      Contractility of myocardial cells depends on the intracellular [Ca2+], which is regulated by Ca2+entry across the cell membrane during the plateau of the action potential and by Ca2+uptake into and release from the sarcoplasmic reticulum (SR).

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      3.4
      Seconds
  • Question 20 - A 74-year-old woman with a history of ischaemic heart disease and heart failure...

    Correct

    • A 74-year-old woman with a history of ischaemic heart disease and heart failure is complaining of worsening oedema, bloating, and a loss of appetite. She has ascites and peripheral oedema on examination. Her oedema is being controlled by an oral diuretic, but it appears that this is no longer enough. You discuss her care with the on-call cardiology registrar, who believes she is very likely to have significant gut oedema that is interfering with her diuretic absorption and that she will need to change her medication.Which of the following oral diuretics is most likely to help you overcome this problem?

      Your Answer: Bumetanide

      Explanation:

      Bumetanide is primarily used in patients with heart failure who have failed to respond to high doses of furosemide. Bumetanide and furosemide differ primarily in terms of bioavailability and pharmacodynamic potency. In the intestine, furosemide is only partially absorbed, with a bioavailability of 40-50 percent. Bumetanide, on the other hand, is almost completely absorbed in the intestine and has a bioavailability of about 80%. As a result, when it has a better bioavailability than furosemide, it is commonly used in patients with gut oedema.When taken alone, Bendroflumethiazide is a moderately potent diuretic that is unlikely to control her oedema.Mannitol is a type of osmotic diuretic used to treat cerebral oedema and high intracranial pressure.Acetazolamide is a weak diuretic that inhibits carbonic anhydrase. It’s a rare occurrence.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      90
      Seconds
  • Question 21 - Which of the following is NOT a typical effect of cortisol: ...

    Correct

    • Which of the following is NOT a typical effect of cortisol:

      Your Answer: Decreased protein catabolism

      Explanation:

      Cortisol is a steroid hormone produced in the zona fasciculata of the adrenal cortex. It is released in response to stress and low blood glucose concentrations.Cortisol acts to: raise plasma glucose by stimulating glycolysis and gluconeogenesis in the liver and inhibiting peripheral glucose uptake into storage tissues, increase protein breakdown in skeletal muscle, skin and bone to release amino acids, increase lipolysis from adipose tissues to release fatty acidsand at higher levels and mimic the actions of aldosterone on the kidney to retain Na+ and water and lose K+ ionssuppress the action of immune cells

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      41.9
      Seconds
  • Question 22 - At which vertebral level does the spinal cord normally end in adults? ...

    Correct

    • At which vertebral level does the spinal cord normally end in adults?

      Your Answer: L1/L2

      Explanation:

      The spinal cord starts at the foramen magnum, where it is continuous with the medulla oblongata, which is the most caudal portion of the brainstem.It then extends inferiorly through the vertebral canal. In adults, it usually ends at the level of the first or second lumbar vertebra.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      3
      Seconds
  • Question 23 - You review a patient with urinary sepsis and decide to start her on...

    Correct

    • You review a patient with urinary sepsis and decide to start her on gentamicin.Which statement about gentamicin is true?

      Your Answer: Ototoxicity is a dose-related effect

      Explanation:

      Gentamicin, an aminoglycoside antibiotic, acts by binding to the 30S subunit of the bacterial ribosome inhibiting the binding of aminoacyl-tRNA, and thus prevents initiation of protein synthesis.Gentamicin is given by injection because it is NOT absorbed orally. It is excreted in the kidneys by glomerular filtrationGentamicin is not to be used for the treatment of Neisseria meningitidis, Neisseria gonorrhoea, or Legionella pneumophila.There is a risk of patient going into shock from lipid A endotoxin release.Two of its most notable side effects are hearing loss reversible nephrotoxicity and which are both dose-related and levels should be monitored in patients.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11.5
      Seconds
  • Question 24 - A 6 year old boy is brought into the ED by his mom...

    Correct

    • A 6 year old boy is brought into the ED by his mom with a rash that is associated with Koplik's spots and a diagnosis of measles is made. What advice should be given about returning to school?

      Your Answer: 4 days from the onset of the rash

      Explanation:

      Prevention of spread of measles is extremely important and infected patients should be isolated. The infectious stage is from 3 days before the rash emerges and patients are advised to stay away from school/nursery/work for 4 days from onset of the rash.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      18.5
      Seconds
  • Question 25 - In patients who are not at risk of hypercapnic respiratory failure but are...

    Correct

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

      Your Answer: 94 - 98%

      Explanation:

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

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      8.2
      Seconds
  • Question 26 - 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
      10.2
      Seconds
  • Question 27 - Antispasmodic drugs are primarily indicated in which of the following conditions: ...

    Correct

    • Antispasmodic drugs are primarily indicated in which of the following conditions:

      Your Answer: Irritable bowel syndrome

      Explanation:

      Antispasmodics, such as antimuscarinics, may be used in the management of irritable bowel syndrome. Other antispasmodics used include direct-acting smooth muscle relaxants such as mebeverine, alverine, and peppermint oil. Antispasmodics are contraindicated in bowel obstruction and severe inflammatory bowel disease. Antispasmodics are occasionally of value in treating abdominal cramp associated with diarrhoea but they should not be used for primary treatment. Antispasmodics should be avoided in young children with gastroenteritis because they are rarely effective and have troublesome side effects. Antimuscarinics are contraindicated in urinary retention.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      12.2
      Seconds
  • Question 28 - What is the interquartile range of the following data set: 5, 10, 15,...

    Incorrect

    • What is the interquartile range of the following data set: 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 60, 70

      Your Answer: 35

      Correct Answer: 30

      Explanation:

      5, 10, 15 /20, 25, 30 /35, 40, 45 /50, 60, 70Sample size (n) = 12Median = [(n+1)/2]th value = (12+1)/2 = 6.5 = halfway between 6th and 7th value = (30 +35)/2 = 32.5The lower (first) quartile = halfway between 15 and 20 = 17.5The upper (third) quartile = halfway between 45 and 50 = 47.5The interquartile range is the difference between the upper quartile and lower quartile = 47.5 – 17.5 = 30

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      15
      Seconds
  • Question 29 - Pre-oxygenation is done prior to intubation to extend the ‘safe apnoea time’.Which lung...

    Correct

    • Pre-oxygenation is done prior to intubation to extend the ‘safe apnoea time’.Which lung volume or capacity is the most important store of oxygen in the body?

      Your Answer: Functional residual capacity

      Explanation:

      The administration of oxygen to a patient before intubation is called pre-oxygenation and it helps extend the ‘safe apnoea time’. The Functional residual capacity (FRC) is the volume of gas that remains in the lungs after normal tidal expiration. It is the most important store of oxygen in the body. The aim of pre-oxygenation is to replace the nitrogen in the FRC with oxygen. Apnoea can be tolerated for longer periods before critical hypoxia develops if the FRC is large. Patients with reduced FRC reach critical hypoxia more rapidly.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      15.1
      Seconds
  • Question 30 - Which of the following best describes the mechanism of action of aspirin: ...

    Correct

    • Which of the following best describes the mechanism of action of aspirin:

      Your Answer: Cyclo-oxygenase (COX) inhibitor

      Explanation:

      Aspirin is a non-steroidal anti-inflammatory drug (NSAID). Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes and the resulting inhibition of prostaglandin synthesis results in analgesic, antipyretic and to a lesser extent anti-inflammatory actions.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      39
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (2/3) 67%
Specific Pathogen Groups (1/2) 50%
Anatomy (3/4) 75%
Lower Limb (1/1) 100%
Cardiovascular (2/3) 67%
Pharmacology (9/12) 75%
Physiology (5/7) 71%
Evidence Based Medicine (1/2) 50%
Statistics (1/2) 50%
Basic Cellular (0/1) 0%
Upper Limb (1/2) 50%
Cardiovascular Pharmacology (2/4) 50%
Infections (1/2) 50%
Immunoglobulins And Vaccines (1/1) 100%
Inflammatory Responses (1/1) 100%
Pathology (2/2) 100%
General Pathology (1/1) 100%
Endocrine (2/2) 100%
Endocrine Physiology (1/1) 100%
Head And Neck (1/1) 100%
Pathogens (1/1) 100%
Respiratory (1/1) 100%
Respiratory Pharmacology (1/1) 100%
Gastrointestinal (1/1) 100%
Respiratory Physiology (1/1) 100%
Central Nervous System (1/1) 100%
Passmed