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  • Question 1 - Lidocaine's antiarrhythmic mode of action is as follows: ...

    Incorrect

    • Lidocaine's antiarrhythmic mode of action is as follows:

      Your Answer: Blocks open Na+ channels

      Correct Answer: Blocks inactivated Na+ channels

      Explanation:

      Lidocaine is a class 1B antidysrhythmic; combines with fast Na channels and thereby inhibits recovery after repolarization, resulting in decreasing myocardial excitability and conduction velocity. However, in ischaemic areas, where anoxia causes depolarisation and arrhythmogenic activity, many Na+ channels are inactivated and therefore susceptible to lidocaine.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      442.2
      Seconds
  • Question 2 - A 30-year-old patient has a mild exacerbation of his asthma. His steroid inhaler...

    Correct

    • A 30-year-old patient has a mild exacerbation of his asthma. His steroid inhaler ran out a couple of weeks ago, and he has not replaced it.Which of these statements describes the mechanism of action of corticosteroids in asthma?

      Your Answer: Reduction of bronchial inflammation

      Explanation:

      Inhaled corticosteroids suppresses airway inflammation seen in asthma by downregulating pro-inflammatory proteins.They also appear to reverse components of asthma-induced structural changes (airway remodelling), including increased vascularity of the bronchial wall.Corticosteroids reduces the number of inflammatory cells (eosinophils, T lymphocytes, mast cells, and dendritic cells) in the airways.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      6.2
      Seconds
  • Question 3 - A 64-year-old lady attends the emergency department with a known brain tumour. Her...

    Correct

    • A 64-year-old lady attends the emergency department with a known brain tumour. Her left eye is directed outwards and downwards, she can't open it, and her pupil is fixed and dilated. The tumour is most likely compressing which of the following structures:

      Your Answer: Oculomotor nerve

      Explanation:

      The oculomotor nerve is the third cranial nerve. It is the main source of innervation to the extraocular muscles and also contains parasympathetic fibres which relay in the ciliary ganglion. Damage to the third cranial nerve may cause diplopia, pupil mydriasis, and/or upper eyelid ptosis. The clinical manifestations of third cranial nerve dysfunction reflect its constituent parts.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      47.2
      Seconds
  • Question 4 - In the Emergency Department, a 35-year-old woman actively seizing is brought in. She...

    Correct

    • In the Emergency Department, a 35-year-old woman actively seizing is brought in. She is quickly shifted into the resuscitation room and is administered a dose of benzodiazepine. The seizure is quickly terminated. Once the patient is stable, she tells you she is a known case of epilepsy and takes phenytoin to control it. Which of the following is the primary mechanism of action of phenytoin?

      Your Answer: Sodium channel blocker

      Explanation:

      Phenytoin is in the anticonvulsants class of drugs and is used in the management and treatment of the following:1. epilepsy2. generalized tonic-clonic seizures3. complex partial seizures4. status epilepticus. It works by inactivating the voltage-gated sodium channels responsible for increasing the action potential. It is non-specific and targets almost all voltage-gated sodium channel subtypes. More specifically, phenytoin prevents seizures by inhibiting the positive feedback loop that results in neuronal propagation of high-frequency action potentials.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      90.1
      Seconds
  • Question 5 - What is the partial pressure of oxygen if it makes up 20.9 percent...

    Incorrect

    • What is the partial pressure of oxygen if it makes up 20.9 percent of the ambient air composition and the atmospheric pressure of ambient air is 760 mmHg?

      Your Answer: 30 mmHg

      Correct Answer: 159 mmHg

      Explanation:

      Ambient air is atmospheric air in its natural state. Ambient air is typically 78.6% nitrogen and 20.9% oxygen. The extra 1% is made up of carbon, helium, methane, argon and hydrogen. The partial pressure of any gas can be calculated using this formula: P = atmospheric pressure (760 mmHg) x percent content in the mixture. Atmospheric pressure is the sum of all of the partial pressures of the atmospheric gases added together: The formula for atmospheric pressure is: Patm = PN2 + PO2 + PH2O + PCO2. The atmospheric pressure is known to be 760 mmHg. The partial pressures of the various gases can be estimated to have partial pressures of approximately 597.4 mmHg for nitrogen, 158.8 mm Hg for oxygen, and 7.6 mmHg for argon.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      41
      Seconds
  • Question 6 - A 56-year-old female presents at the hospital with a diabetic foot ulcer that...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      33.5
      Seconds
  • Question 7 - A 70-year-old woman presents with right-sided loss of pain and temperature sense on...

    Incorrect

    • A 70-year-old woman presents with right-sided loss of pain and temperature sense on the body as well as left-sided loss of pain and temperature sense on the face. She also has complaints of vertigo, nausea, and tinnitus. Further examination of her cranial nerves suggest the presence of Horner's Syndrome. An MRI and CT scan was ordered and results showed that she is suffering from a left-sided stroke. Branches of which of the following arteries are most likely implicated in the case?

      Your Answer: Basilar artery

      Correct Answer: Posterior inferior cerebellar artery

      Explanation:

      Wallenberg syndrome is also known as lateral medullary syndrome and posterior inferior cerebellar artery syndrome. It is the most common posterior circulation ischemic stroke syndrome. The primary pathology of Wallenberg syndrome is occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches.It is characterized by vertigo with nystagmus, nausea and vomiting, and sometimes hiccups, dysphonia, dysarthria, and dysphagia often present with ipsilateral loss of gag reflex, ipsilateral ataxia with a tendency to fall to the ipsilateral side, pain and numbness with impaired facial sensation on the face, impaired taste sensation, and impaired pain and temperature sensation in the arms and legs.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      18.1
      Seconds
  • Question 8 - Which of the following is NOT a feature characteristic of intravascular haemolysis: ...

    Incorrect

    • Which of the following is NOT a feature characteristic of intravascular haemolysis:

      Your Answer: Methaemalbuminaemia

      Correct Answer: Bilirubinuria

      Explanation:

      Features of intravascular haemolysis include:haemoglobinaemia, methaemalbuminaemia, haemoglobinuria (dark urine) and haemosiderinuria

    • This question is part of the following fields:

      • Haematology
      • Pathology
      19.4
      Seconds
  • Question 9 - A 43-year old male is taken to the Emergency Room for a lacerated...

    Correct

    • A 43-year old male is taken to the Emergency Room for a lacerated wound on the abdomen, situated above the umbilicus. A short segment of the small bowel has herniated through the wound.Which of these anatomic structures is the deepest structure injured in the case above?

      Your Answer: Transversalis fascia

      Explanation:

      The following structures are the layers of the anterior abdominal wall from the most superficial to the deepest layer:SkinFatty layer of the superficial fascia (Camper’s fascia)Membranous layer of the superficial fascia (Scarpa’s fascia)Aponeurosis of the external and internal oblique musclesRectus abdominis muscleAponeurosis of the internal oblique and transversus abdominisFascia transversalisExtraperitoneal fatParietal peritoneum

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      5.4
      Seconds
  • Question 10 - A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a...

    Correct

    • A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a course of antibioticsWhich of the antibiotics listed below is MOST likely to be the cause? 

      Your Answer: Ciprofloxacin

      Explanation:

      Tendinopathy and spontaneous tendon rupture are caused by fluoroquinolones, which are an uncommon but well-known cause. Tendon problems caused by fluoroquinolones are expected to affect 15 to 20 people per 100,000. Patients over the age of 60 are most likely to develop them.It usually affects the Achilles tendon, but it has also been described in cases involving the quadriceps, peroneus brevis, extensor pollicis longus, long head of biceps brachii, and rotator cuff tendons. The exact aetiology is uncertain, although the fluoroquinolone medication is thought to obstruct collagen activity and/or cut off blood supply to the tendon.Other factors linked to tendon rupture spontaneously include:GoutTreatment with corticosteroidsHypercholesterolaemiaLong-term dialysisKidney transplantRheumatoid arthritis 

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      4.7
      Seconds
  • Question 11 - Oculomotor (CN III) palsy with sparing of the pupillary reflex is most likely...

    Incorrect

    • Oculomotor (CN III) palsy with sparing of the pupillary reflex is most likely caused by which of the following:

      Your Answer: Aneurysm of the posterior communicating artery

      Correct Answer: Diabetes mellitus

      Explanation:

      Compressive causes of CN III palsy cause early pupillary dilatation because the parasympathetic fibres run peripherally in the nerve and are easily compressed. In diabetes mellitus the lesions are ischaemic rather than compressive and therefore typically affect the central fibres resulting in pupillary sparing.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      22.8
      Seconds
  • Question 12 - Which family of receptors does the glucagon receptor belong? ...

    Correct

    • Which family of receptors does the glucagon receptor belong?

      Your Answer: G-protein coupled receptors

      Explanation:

      Glucagon binds to class B G-protein coupled receptors and activates adenylate cyclase, increasing cAMP intracellularly. This activates protein kinase A. Protein kinase A phosphorylates and activates important enzymes in target cells.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      21.7
      Seconds
  • Question 13 - An analytical study is conducted to compare the risk of stroke between Ticagrelor...

    Incorrect

    • An analytical study is conducted to compare the risk of stroke between Ticagrelor therapy and Warfarin therapy among patients with atrial fibrillation. The following is obtained from the study:No. of patients who took Ticagrelor: 300No. of patients who took Ticagrelor and suffered a stroke: 30No. of patients who took Warfarin: 500No. of patients who took Warfarin and suffered a stroke: 20Compute for the absolute risk reduction of a stroke, with Warfarin as the standard of treatment.

      Your Answer: 0.04

      Correct Answer: -0.06

      Explanation:

      Absolute risk reduction (ARR) is computed as the difference between the absolute risk in the control group (ARC) and the absolute risk in the treatment group (ART).Since Warfarin is the standard of treatment, Warfarin is considered as the control group.ARR = ARC-ARTARR = (20/500) – (30/300)ARR = -0.06This means that there is increased risk of stroke in the treatment group, which is the Ticagrelor group.

    • This question is part of the following fields:

      • Evidence Based Medicine
      47.9
      Seconds
  • Question 14 - For which of the following infections is phenoxymethylpenicillin (penicillin V) primarily used? ...

    Correct

    • For which of the following infections is phenoxymethylpenicillin (penicillin V) primarily used?

      Your Answer: Streptococcal tonsillitis

      Explanation:

      Phenoxymethylpenicillin (penicillin V) is less active than benzylpenicillin but both have similar antibacterial spectrum. Because penicillin V is gastric-acid stable, it is suitable for oral administration, but should not be used for serious infections as absorption can be unpredictable and plasma concentrations can be variable. Its uses are:1. mainly for respiratory tract infections in children2. for streptococcal tonsillitis 3. for continuing treatment after one or more injections of benzylpenicillin when clinical response has begun. 4. for prophylaxis against streptococcal infections following rheumatic fever and against pneumococcal infections following splenectomy or in sickle-cell disease. It should not be used for meningococcal or gonococcal infections.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11.5
      Seconds
  • Question 15 - A 30-year-old female presented to the Emergency Department after a fall during a...

    Correct

    • A 30-year-old female presented to the Emergency Department after a fall during a hiking expedition caused severe pain in her left arm and wrist drop. An X-ray revealed a mid-shaft fracture of the humerus, which most likely damaged the radial nerve. Which one of the following statements best describes the healing process of peripheral nerves?

      Your Answer: Peripheral nerve fibres regenerate at around 1mm per day

      Explanation:

      Peripheral nerves are nerves that lie outside the brain and spinal cord. Peripheral nerves readily regenerate, while central nervous system axonal injury does not spontaneously regenerate. If there is damage to the axons of peripheral nerves, the nerves will regenerate at a slow rate of 1 mm per day. The slow regeneration process may lead to muscle atrophy before regeneration is complete. Each peripheral nerve has a single cell body that supplies nutrients to the growing nerve fibre. The cell body does not undergo mitosis; only the axon is regenerated.Schwann cells of the peripheral nervous system provide support for this process, while the analogous oligodendrocytes of the central nervous system do not. Schwann cells themselves do not cause regeneration. Schwann cells provide myelin for myelinated fibres and surround non-myelinated fibres with their cytoplasm. If an axon is completely severed, as in the case of amputation, the axonal fibres regenerating from the cell body may never find their original route back to the muscle. Instead, they may form a traumatic neuroma, a painful collection of nerve fibres and myelin.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      27.4
      Seconds
  • Question 16 - One of your patients is undergoing resuscitation and is in septic shock. The...

    Correct

    • One of your patients is undergoing resuscitation and is in septic shock. The intensive care outreach team arrives to assess them and determines that a dobutamine infusion should be started.Which of the following receptors does dobutamine primarily affect?

      Your Answer: Beta-1 receptors

      Explanation:

      Dobutamine is a synthetic isoprenaline derivative that is used to provide inotropic support to patients with low cardiac output caused by septic shock, myocardial infarction, or other cardiac conditions.Dobutamine is a sympathomimetic drug that stimulates beta-1 adrenergic receptors in the heart to produce its primary effect. As a result, it has inotropic properties that increase cardiac contractility and output. It also has a small amount of alpha1- and beta-2-adrenergic activity.A summary of the mechanism and effects of different inotropic agents is shown below: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
      28.7
      Seconds
  • Question 17 - A 29-year-old man is diagnosed with a severe case of asthma.In the treatment...

    Correct

    • A 29-year-old man is diagnosed with a severe case of asthma.In the treatment of acute asthma in adults, which of the following is NOT recommended? 

      Your Answer: Nebulised magnesium

      Explanation:

      There is no evidence to support the use of nebulized magnesium sulphate in the treatment of adults at this time.In adults with acute asthma, the following medication dosages are recommended:By using an oxygen-driven nebuliser, you can get 5 milligrams of salbutamol.500 mcg ipratropium bromide in an oxygen-driven nebuliserOral prednisolone 40-50 mg100 mg hydrocortisone intravenous1.2-2 g magnesium sulphate IV over 20 minutesWhen inhaled treatment is ineffective, intravenous salbutamol (250 mcg IV slowly) may be explored (e.g. a patient receiving bag-mask ventilation).Following senior counsel, current ALS recommendations propose that IV aminophylline be explored in severe or life-threatening asthma. If utilized, a loading dose of 5 mg/kg should be administered over 20 minutes, then a 500-700 mcg/kg/hour infusion should be given. To avoid toxicity, serum theophylline levels should be kept below 20 mcg/ml.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      21.8
      Seconds
  • Question 18 - A blood test of a 7-year-old child with a 6-day history of bloody...

    Correct

    • A blood test of a 7-year-old child with a 6-day history of bloody diarrhoea reveals a low platelet count, anaemia, and impaired kidney function. What bacteria is suspected of causing such a condition?

      Your Answer: Escherichia coli

      Explanation:

      Escherichia coli produces shiga toxin that causes diarrhoea, hemorrhagic colitis, and haemolytic uremic syndrome. Haemolytic uremic syndrome is characterized by anaemia, thrombocytopenia, and acute renal failure. Transmission of E. coli is possible after consuming contaminated, undercooked drinks and foods. E. coli enters the body via the faecal-oral pathway.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      27
      Seconds
  • Question 19 - C3 deficiency leads to particular susceptibility of infection with which of the following:...

    Incorrect

    • C3 deficiency leads to particular susceptibility of infection with which of the following:

      Your Answer: Intracellular bacteria

      Correct Answer: Encapsulated bacteria

      Explanation:

      Macrophages and neutrophils have C3b receptors and they phagocytose C3b-coated cells. C3 deficiency thus leads to increased susceptibility of infection with encapsulated organisms (e.g. S. pneumoniae, H. influenzae).The early stages of the complement cascade leading to coating of the cells with C3b can occur by two different pathways:The classical pathway usually activated by IgG or IgM coating of cellsThe alternative pathway which is more rapid and activated by IgA, endotoxin and other factors

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      7.6
      Seconds
  • Question 20 - Reed-Sternberg cells are characteristic of which of the following malignancies: ...

    Correct

    • Reed-Sternberg cells are characteristic of which of the following malignancies:

      Your Answer: Hodgkin lymphoma

      Explanation:

      Lymphomas are a group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and other lymphoid tissue and cause the characteristic clinical feature of lymphadenopathy. The major subdivision of lymphomas is into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) and this is based on the histological presence of Reed-Sternberg cells present in HL. Hodgkin lymphoma can present at any age but is rare in children and has a peak incidence in young adults. There is an almost 2 : 1 male predominance. Most patients present with painless, asymmetrical, firm and discrete enlargement of superficial lymph nodes. Cervical nodes are involved in 60-70% of cases, axillary nodes in 10-15% and inguinal nodes in 6-12%. Modest splenomegaly occurs during the course of the disease in 50% of patients; the liver may also be enlarged. Bone marrow failure involvement is unusual in early disease. The prognosis depends on age, stage and histology, but overall approximately 85% of patients are cured. Alcohol‐induced pain and pruritus are two well‐known but rare symptoms in HL.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      2.8
      Seconds
  • Question 21 - Which of the following is NOT a common effect of etomidate: ...

    Correct

    • Which of the following is NOT a common effect of etomidate:

      Your Answer: Significant hypotension

      Explanation:

      Etomidate causes less hypotension than thiopental sodium and propofol during induction. However, it is associated with a high incidence of extraneous muscle movements, which can be minimised by an opioid analgesic or a short-acting benzodiazepine given prior to induction. Pain on injection is common and there is a high rate of thrombophlebitis in the postoperative period. Postoperative nausea and vomiting commonly occur. Etomidate suppresses adrenocortical function, particularly during continuous administration, and it should not be used for maintenance of anaesthesia. It should be used with caution in patients with underlying adrenal insufficiency, for example, those with sepsis.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      55.5
      Seconds
  • Question 22 - A 32 year old man is brought to ED having been thrown off...

    Correct

    • A 32 year old man is brought to ED having been thrown off his motorbike. Following initial resuscitation and ruling out life-threatening injuries, you establish the patient has weakness of hip flexion. Which of the following nerves has most likely been injured:

      Your Answer: Femoral nerve

      Explanation:

      Flexion of the hip is produced by the iliacus, the psoas major, the sartorius, rectus femoris and the pectineus muscles. The femoral nerve innervates the iliacus, pectineus, sartorius and quadriceps femoris muscles, and supplies skin on the anterior thigh, anteromedial knee and medial leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      35.5
      Seconds
  • Question 23 - If a patient dislocated his right shoulder and has been referred to the...

    Correct

    • If a patient dislocated his right shoulder and has been referred to the orthopaedic outpatient department for a follow-up after a successful reduction, which of the following is the most important position for him to avoid holding his arm in until he is seen in the clinic?

      Your Answer: Arm at 90 degrees to side with palm up

      Explanation:

      The arm should be placed in a poly-sling that should be worn for about two weeks. A physiotherapist may give gentle movements for the arm to help in reducing stiffness and in relieving the pain. It is important that the patient must avoid positions that could cause re-dislocation.The most important position to avoid is the arm being held out at 90 degrees to the side with the palm facing upwards, especially if a force is being applied.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      32.2
      Seconds
  • Question 24 - A patient presents with a necrolytic migratory rash. Her blood serum glucagon concentration...

    Incorrect

    • A patient presents with a necrolytic migratory rash. Her blood serum glucagon concentration is 1246 pg/mL. Following further investigations, she is diagnosed with glucagonoma.Which SINGLE statement regarding glucagon is true?

      Your Answer: It stimulates glycolysis

      Correct Answer: It makes fatty acids available for oxidation

      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
      19.8
      Seconds
  • Question 25 - The arterial blood gas (ABG) of a 56-year-old woman shows type A lactic...

    Correct

    • The arterial blood gas (ABG) of a 56-year-old woman shows type A lactic acidosis.What is the most likely cause of her lactic acidosis?

      Your Answer: Left ventricular failure

      Explanation:

      Lactic acidosis is a common finding in critically ill patients and commonly associated with other serious underlying pathologies. It occurs when pH is 5 mmol/L. Anion gap is increased in lactic acidosis.Acquired lactic acidosis is classified into two subtypes:Type A: lactic acidosis due to tissue hypoxia andType B: due to non-hypoxic processes affecting the production and elimination of lactateSome causes of type A and type B lactic acidosis include:Type A lactic acidosisLeft ventricular failureSevere anaemiaShock (including septic shock)AsphyxiaCardiac arrestCO poisoningRespiratory failureSevere asthma and COPDType B lactic acidosis:Regional hypoperfusionRenal failureLiver failureSepsis (non-hypoxic sepsis)Thiamine deficiencyAlcoholic ketoacidosisDiabetic ketoacidosisCyanide poisoningMethanol poisoningBiguanide poisoning

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      8.4
      Seconds
  • Question 26 - A 71-year-old man treated with antibiotics for a chest infection returns with a...

    Correct

    • A 71-year-old man treated with antibiotics for a chest infection returns with a profuse, offensive smelling diarrhoea. A diagnosis of Clostridium difficile diarrhoea is made after investigations.The action most effective at minimizing spread to other patients is?

      Your Answer: Hand washing

      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.Wearing an apron and gloves, and isolation to a side room are important contact precautions. They are, however, ineffective if hand washing is neglected.Although oral vancomycin is the first-line treatment for C. difficile associated diarrhoea, it will not limit patient to patient spread.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      28
      Seconds
  • Question 27 - Flucloxacillin is used first line for all of the following infections EXCEPT for:...

    Incorrect

    • Flucloxacillin is used first line for all of the following infections EXCEPT for:

      Your Answer: Widespread impetigo

      Correct Answer: Otitis media

      Explanation:

      Flucloxacillin 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. Amoxicillin is first line for acute otitis media.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      18.1
      Seconds
  • Question 28 - Which of the following is the primary indication for loop diuretics? ...

    Correct

    • Which of the following is the primary indication for loop diuretics?

      Your Answer: Acute pulmonary oedema

      Explanation:

      Loop diuretics have long been the cornerstone of pulmonary oedema treatment, with furosemide being the most commonly used of these drugs. Premedication with drugs that decrease preload (e.g., nitro-glycerine [NTG]) and afterload (e.g., angiotensin-converting enzyme [ACE] inhibitors) before the administration of loop diuretics can prevent adverse hemodynamic changes.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      7.6
      Seconds
  • Question 29 - The interquartile range (IQ) is often displayed using which of the following: ...

    Correct

    • 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.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      8.3
      Seconds
  • Question 30 - The most common site of ectopic pregnancy is? ...

    Correct

    • The most common site of ectopic pregnancy is?

      Your Answer: Ampulla of Fallopian tube

      Explanation:

      Nearly 95% of ectopic pregnancies are implanted in the various segments of the fallopian tube and give rise to fimbrial, ampullary, isthmic, or interstitial tubal pregnancies. The ampulla is the most frequent site, followed by the isthmus. The remaining 5% of non tubal ectopic pregnancies implant in the ovary, peritoneal cavity, cervix, or prior caesarean scar.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      2.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (1/2) 50%
Pharmacology (9/11) 82%
Respiratory Pharmacology (2/2) 100%
Anatomy (5/7) 71%
Cranial Nerve Lesions (1/2) 50%
CNS Pharmacology (1/1) 100%
Physiology (2/4) 50%
Respiratory Physiology (0/1) 0%
Endocrine Pharmacology (1/1) 100%
Central Nervous System (0/1) 0%
Haematology (1/2) 50%
Pathology (2/4) 50%
Abdomen And Pelvis (2/2) 100%
Infections (2/3) 67%
Endocrine Physiology (1/2) 50%
Evidence Based Medicine (1/2) 50%
General Pathology (1/1) 100%
Cardiovascular Pharmacology (1/1) 100%
Microbiology (2/2) 100%
Pathogens (1/1) 100%
Immune Responses (0/1) 0%
Anaesthesia (1/1) 100%
Lower Limb (1/1) 100%
Upper Limb (1/1) 100%
Renal Physiology (1/1) 100%
Specific Pathogen Groups (1/1) 100%
Statistics (1/1) 100%
Passmed