00
Correct
00
Incorrect
00 : 00 : 0 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - In patients requiring oxygen, who are at risk of hypercapnic respiratory failure, oxygen...

    Incorrect

    • In patients requiring oxygen, who are at risk of hypercapnic respiratory failure, oxygen saturations should be maintained at:

      Your Answer: 94 - 98%

      Correct Answer: 88 - 92%

      Explanation:

      A lower target of 88 – 92% oxygen saturation is indicated for patients at risk of hypercapnic respiratory failure e.g. patients with COPD. Until blood gases can be measured, initial oxygen should be given using a controlled concentration of 28% or less, titrated towards the SpO2 of 88 – 92%. The aim is to provide the patient with enough oxygen to achieve an acceptable arterial oxygen tension without worsening carbon dioxide retention and respiratory acidosis.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      5.6
      Seconds
  • Question 2 - You're evaluating a 37-year-old woman who is 12 weeks pregnant. She has experienced...

    Correct

    • You're evaluating a 37-year-old woman who is 12 weeks pregnant. She has experienced vaginal bleeding.Which of the following anti-D statements is correct?

      Your Answer: Routine antenatal prophylaxis is recommended for RhD negative women at 28 and 34 weeks

      Explanation:

      Anti-D is an IgG antibody that targets the antigen Rhesus D (RhD). Plasma from rhesus-negative donors who have been immunised against the anti-D-antigen is used to make anti-D immunoglobulin.Only RhD negative women are given Anti-D Ig. Women who are RhD negative do not have the RhD antigen on their RBC. If a foetus has the RhD antigen (i.e. is RhD positive) and the mother is exposed to foetal blood, she may develop antibodies to RhD that pass through the placenta and attack foetal red cells (resulting in newborn haemolytic disease). Anti-D is given to bind and neutralise foetal red cells in the maternal circulation before an immune response is triggered. In the event of a sensitising event, 500 IU Anti-D Ig should be administered intramuscularly. The following are examples of potentially sensitising events:BirthHaemorrhage during pregnancyMiscarriageEctopic pregnancyDeath within the wombAmniocentesisChorionic villus samplingTrauma to the abdomenThe sooner anti-D is given in the event of a sensitising event, the better; however, it is most effective within 72 hours, and the BNF states that it is still likely to have some benefit if given outside of this time frame.At 28 and 34 weeks, RhD negative women should receive routine antenatal prophylaxis. This is regardless of whether they have previously received Anti-D for a sensitising event during the same pregnancy.Prophylactic anti-D is not necessary before 12 weeks gestation, as confirmed by scan, in uncomplicated miscarriage (where the uterus is not instrumented), or mild, painless vaginal bleeding, as the risk of foeto-maternal haemorrhage (FMH) is negligible. In cases of therapeutic termination of pregnancy, whether by surgical or medical means, 250 IU of prophylactic anti-D immunoglobulin should be given to confirmed RhD negative women who are not known to be RhD sensitised.

    • This question is part of the following fields:

      • Immunological Products & Vaccines
      • Pharmacology
      19.5
      Seconds
  • Question 3 - Naloxone is a reversal agent for which of the following groups of drugs:...

    Correct

    • Naloxone is a reversal agent for which of the following groups of drugs:

      Your Answer: Opioids

      Explanation:

      Naloxone is a specific antagonist of mu(μ)-opioid receptors, the specific antidote for opioid overdose and will reverse respiratory depression and coma if given at sufficient dosage. The initial dose is usually 0.8 mg (2 mL) intravenously (the dose range suggested by BNF is 0.4-2 mg). It can also be given by intramuscular injection if the intravenous route is not feasible.As naloxone has a shorter duration of action than most opioids, close monitoring and repeated injections are necessary according to the respiratory rate and depth of coma. The dose is generally repeated every 2-3 minutes to a maximum of 10 mg. When repeated doses are needed, naloxone may be given by a continuous infusion adjusted according to the vital signs. Initially, the infusion rate can be set at 60% of the initial resuscitative IV dose per hour.In opioid addicts, naloxone administration may precipitate a withdrawal syndrome with abdominal cramps, nausea and diarrhoea, but these usually settle within 2 hours.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      7.7
      Seconds
  • Question 4 - A patient who has a nerve injury has sparing of the upper half...

    Correct

    • A patient who has a nerve injury has sparing of the upper half of the orbicularis oculi muscle but not the lower half. Which branch of the facial nerve supplies the lower half of the orbicularis oculi?

      Your Answer: Zygomatic branch

      Explanation:

      The facial nerve divides into five terminal branches once in the parotid gland. 1. The temporal branch innervates muscles in the temple, forehead and supraorbital areas.2. The zygomatic branch innervates muscles in the infraorbital area, the lateral nasal area and the upper lip.3. The buccal branch innervates muscles in the cheek, the upper lip and the corner of the mouth. 4. The marginal mandibular branch innervates muscles of the lower lip and chin. 5. The cervical branch innervates the platysma muscle.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      22.7
      Seconds
  • Question 5 - A 16-year-old male with a known case of Haemophilia A is referred to...

    Correct

    • A 16-year-old male with a known case of Haemophilia A is referred to your orthopaedic clinic for evaluation and aspiration of a hemarthrosis of the left knee joint. Out of the modes of inheritance listed below, which one is present in this disease?

      Your Answer: X-linked recessive

      Explanation:

      All the Haemophilia’s have an X-linked recessive inheritance pattern, so they only manifest in male patients. Diseases with a mitochondrial inheritance pattern include MELAS syndrome, Leigh syndrome, LHON and MERRF syndrome. Autosomal dominant disorders include Huntingdon disease and Marfan syndrome. X-linked dominant diseases include Fragile X syndrome. Autosomal recessive diseases include cystic fibrosis and sickle cell disease.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      4.2
      Seconds
  • Question 6 - Due to a traffic accident, a male patient was unable to flex his...

    Incorrect

    • Due to a traffic accident, a male patient was unable to flex his arm at the glenohumeral joint. Based on the patient’s current condition, which nerve is most likely damaged?

      Your Answer: Axillary and long thoracic nerve

      Correct Answer: Axillary and suprascapular nerve

      Explanation:

      A suprascapular nerve injury causes numbness in the shoulder, as well as weakness in abduction and external rotation. Damage to the axillary nerve can result in shoulder or arm muscle weakness, as well as difficulty lifting the arm. This is because the deltoid and supraspinatus muscles, which are innervated by the axillary and suprascapular nerves, are responsible for abduction of the arm at the shoulder joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      19
      Seconds
  • Question 7 - Cystic fibrosis patients have a weakened lung surfactant system. Which of the following...

    Incorrect

    • Cystic fibrosis patients have a weakened lung surfactant system. Which of the following cell types is in charge of surfactant secretion?

      Your Answer: Type I pneumocytes

      Correct Answer: Type II pneumocytes

      Explanation:

      Alveolar type II cells are responsible for four primary functions: surfactant synthesis and secretion, xenobiotic metabolism, water transepithelial transport, and alveolar epithelium regeneration following lung injury.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      15.9
      Seconds
  • Question 8 - Digoxin exhibits its positive inotropic effect by which of the following mechanisms: ...

    Correct

    • Digoxin exhibits its positive inotropic effect by which of the following mechanisms:

      Your Answer: Inhibits the Na+/K+ pump on the myocyte membrane

      Explanation:

      Cardiac glycosides (e.g. digoxin) slow the removal of Ca2+from the cell by inhibiting the membrane Na+pump (Na+/K+ATPase) which generates the Na+gradient required for driving the export of Ca2+by Na+/Ca2+exchange; consequently the removal of Ca2+from the myocyte is slowed and more Ca2+is available for the next contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      49.4
      Seconds
  • Question 9 - Which of the following drugs used in the management of hyperkalaemia does not...

    Correct

    • Which of the following drugs used in the management of hyperkalaemia does not affect serum potassium levels:

      Your Answer: Calcium gluconate

      Explanation:

      Calcium gluconate is given to antagonise cardiac cell membrane excitability to reduce the risk of arrhythmias. It has no effect on serum potassium levels unlike the alternative drugs listed above.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      28.1
      Seconds
  • Question 10 - Which of the following is a primary action of calcitonin: ...

    Correct

    • Which of the following is a primary action of calcitonin:

      Your Answer: Decreased bone resorption through inhibition of osteoclast activity

      Explanation:

      Calcitonin is a 32 amino acid polypeptide that is primarily synthesised and released by the parafollicular cells (C-cells) of the thyroid gland in response to rising or high levels of plasma Ca2+ions. Its primary role is to reduce the plasma calcium concentration, therefore opposing the effects of parathyroid hormone.Secretion of calcitonin is stimulated by:- Increased plasma calcium concentration- Gastrin- Pentagastrin- The main actions of calcitonin are:- Inhibition of osteoclastic activity (decreasing calcium and phosphate resorption from bone)- Stimulation of osteoblastic activity- Decreases renal calcium reabsorption- Decreases renal phosphate reabsorption

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      63.2
      Seconds
  • Question 11 - What is the mechanism of action of chlorphenamine: ...

    Correct

    • What is the mechanism of action of chlorphenamine:

      Your Answer: H1-receptor antagonist

      Explanation:

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

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      2.8
      Seconds
  • Question 12 - You suspect that your patient with polycystic kidney disease has developed a berry...

    Incorrect

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

      Your Answer: Posterior communicating artery

      Correct Answer: Anterior communicating artery

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      26.3
      Seconds
  • Question 13 - During bedside rounds, an 82-year old female in the Medicine Ward complains of...

    Correct

    • During bedside rounds, an 82-year old female in the Medicine Ward complains of pain and tingling of all fingers of the right hand. The attending physician is considering carpal tunnel syndrome.Which of the following is expected to undergo atrophy in carpal tunnel syndrome?

      Your Answer: The thenar eminence

      Explanation:

      Carpal tunnel syndrome (CTS) is an entrapment neuropathy caused by compression of the median nerve as it travels through the wrist’s carpal tunnel. It is the most common nerve entrapment neuropathy, accounting for 90% of all neuropathies. Early symptoms of carpal tunnel syndrome include pain, numbness, and paraesthesia’s. These symptoms typically present, with some variability, in the thumb, index finger, middle finger, and the radial half (thumb side) of the ring finger. Pain also can radiate up the affected arm. With further progression, hand weakness, decreased fine motor coordination, clumsiness, and thenar atrophy can occur.The muscles innervated by the median nerve can be remembered using the mnemonic ‘LOAF’:L– lateral two lumbricalsO– Opponens pollicisA– Abductor pollicisF– Flexor pollicis brevisIn the early presentation of the disease, symptoms most often present at night when lying down and are relieved during the day. With further progression of the disease, symptoms will also be present during the day, especially with certain repetitive activities, such as when drawing, typing, or playing video games. In more advanced disease, symptoms can be constant.Typical occupations of patients with carpal tunnel syndrome include those who use computers for extended periods of time, those who use equipment that has vibration such as construction workers, and any other occupation requiring frequent, repetitive movement.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      33.6
      Seconds
  • Question 14 - A 27-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.In...

    Correct

    • A 27-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.In which of the following nerves is the gluteus maximus muscle innervated by?

      Your Answer: Inferior gluteal nerve

      Explanation:

      The gluteal muscles are a group of muscles that make up the buttock area. These muscles include: gluteus maximus, gluteus medius. and gluteus minimus.The gluteus maximus is the most superficial as well as largest of the three muscles and makes up most of the shape and form of the buttock and hip area. It is a thick, fleshy muscle with a quadrangular shape. It is a large muscle and plays a prominent role in the maintenance of keeping the upper body erect.The innervation of the gluteus maximus muscle is from the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      5.7
      Seconds
  • Question 15 - 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
      13.1
      Seconds
  • Question 16 - All of the following statements are incorrect about insulin except: ...

    Incorrect

    • All of the following statements are incorrect about insulin except:

      Your Answer: The effects of insulin are mediated by a G-protein coupled receptor.

      Correct Answer: Proinsulin is cleaved into insulin and C peptide.

      Explanation:

      Proinsulin is synthesised as a single-chain peptide. A connecting peptide (C peptide) within storage granules is removed by proteases to yield insulin. Insulin:1. is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds. 2. is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas. 3. release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin. However, most output is driven by the rise in plasma glucose concentration that occurs after a meal. 4. effects are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      308.5
      Seconds
  • Question 17 - The renal team is currently prescribing erythropoietin to a patient with chronic kidney...

    Correct

    • The renal team is currently prescribing erythropoietin to a patient with chronic kidney disease.Which of the following statements about erythropoietin is correct?

      Your Answer: It protects red blood cell progenitors from apoptosis

      Explanation:

      Erythropoietin is a glycoprotein hormone that regulates the formation of red blood cells (red cell production). It is mostly produced by interstitial fibroblasts in the kidney, which are located near the PCT. It is also produced in the liver’s perisinusoidal cells, however this is more common during the foetal and perinatal periods.The kidneys produce and secrete erythropoietin in response to hypoxia. On red blood cells, erythropoietin has two main effects:- It encourages stem cells in the bone marrow to produce more red blood cells.- It protects red blood cell progenitors and precursors from apoptosis by targeting them in the bone marrow.As a result of the increased red cell mass, the oxygen-carrying capacity and oxygen delivery increase.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      33.9
      Seconds
  • Question 18 - An 18-year-old student presents with a 1-week history of sore throat, low grade...

    Correct

    • An 18-year-old student presents with a 1-week history of sore throat, low grade fever, and malaise. Upon history taking, she noted that she had a fine rash over her body a week ago that quickly fades. Further examination and observation was done and the presence of mild splenomegaly was noted. Her test shows positive for heterophile antibody test, suspecting a diagnosis of infectious mononucleosis.Which of the following characteristics is mostly associated with the diagnosis of infectious mononucleosis?

      Your Answer: Atypical lymphocytes

      Explanation:

      Epstein-Barr virus causes infectious mononucleosis which is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue and fever. It is accompanied by atypical large peripheral blood lymphocytes. These atypical lymphocytes, also known as Downey cells, are actually activated CD8 T lymphocytes, most of which are responding to EBV-infected cells.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      30.5
      Seconds
  • Question 19 - On her most recent blood tests, a 55 year-old female with a history of hypertension...

    Incorrect

    • On her most recent blood tests, a 55 year-old female with a history of hypertension was discovered to be hypokalaemic. She  is diagnosed with primary hyperaldosteronism.Which of the following is a direct action of aldosterone?

      Your Answer: Reabsorption of Na + into the proximal convoluted tubule

      Correct Answer: Secretion of H + into the distal convoluted tubule

      Explanation:

      Aldosterone is a steroid hormone produced in the adrenal cortex’s zona glomerulosa. It is the most important mineralocorticoid hormone in the control of blood pressure. It does so primarily by promoting the synthesis of Na+/K+ATPases and the insertion of more Na+/K+ATPases into the basolateral membrane of the nephron’s distal tubules and collecting ducts, as well as stimulating apical sodium and potassium channel activity, resulting in increased sodium reabsorption and potassium secretion. This results in sodium conservation, potassium secretion, water retention, and a rise in blood volume and blood pressure.Aldosterone is produced in response to the following stimuli:Angiotensin II levels have risen.Potassium levels have increased.ACTH levels have risen.Aldosterone’s principal actions are as follows:Na+ reabsorption from the convoluted tubule’s distal endWater resorption from the distal convoluted tubule (followed by Na+)Cl is reabsorbed from the distal convoluted tubule.K+ secretion into the convoluted distal tubule’s H+ secretion into the convoluted distal tubule’s 

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      91.3
      Seconds
  • Question 20 - What is the direct mechanism of action of digoxin as a positive inotrope:...

    Correct

    • What is the direct mechanism of action of digoxin as a positive inotrope:

      Your Answer: Inhibition of Na+/K+ ATPase pump

      Explanation:

      Digoxin directly inhibits membrane Na+/K+ ATPase, which is responsible for Na+/K+ exchange across the myocyte cell membrane. This increases intracellular Na+ and produces a secondary increase in intracellular Ca2+ that increases the force of myocardial contraction. The increase in intracellular Ca2+ occurs because the decreased Na+ gradient across the membrane reduces the extrusion of Ca2+ by the Na+/Ca2+ exchanger that normally occurs during diastole. Digoxin and K+ ions compete for the receptor on the outside of the muscle cell membrane, and so the effects of digoxin may be dangerously increased in hypokalaemia.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      20.3
      Seconds
  • Question 21 - A 36-year-old man presented to the emergency room with a two-week history of...

    Incorrect

    • A 36-year-old man presented to the emergency room with a two-week history of shortness of breath, fevers, and malaise. A chest X-ray was ordered and the results confirmed the diagnosis of a right middle lobe pneumonia. Which of the following structures of the heart lies closest to the consolidation?

      Your Answer: Right ventricle

      Correct Answer: Right atrium

      Explanation:

      In its typical anatomical orientation, the heart has 5 surfaces formed by different internal divisions of the heart:Anterior (or sternocostal) – Right ventriclePosterior (or base) – Left atriumInferior (or diaphragmatic) – Left and right ventriclesRight pulmonary – Right atriumLeft pulmonary – Left ventricleThe silhouette sign of Felson is with respect to the right middle lobe. The right heart border should have a distinct appearance due to the right atrium abutting aerated right middle lobe. The consolidation in the right middle lobe has resulted in loss of this silhouette.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      12.1
      Seconds
  • Question 22 - You are about to perform an emergency pericardiocentesis on a 26-year-old male who...

    Correct

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

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

      Explanation:

      Pericardiocentesis is a procedure that removes excess fluid from the pericardium. As a result, it’s used in cases of cardiac tamponade, which occurs when there’s too much fluid in the space around the heart. During the procedure, a needle and a small catheter are inserted 1 to 2 cm inferior and to the left of the xiphochondral junction into the pericardial cavity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      8.2
      Seconds
  • Question 23 - Due to severe palpitations, a 28-year-old woman is transported to the Emergency Department...

    Incorrect

    • Due to severe palpitations, a 28-year-old woman is transported to the Emergency Department by ambulance. Her heart rate is 180 beats per minute, and the rhythm strip shows supraventricular tachycardia. You intend to give adenosine.Which of the following is NOT a contraindication for adenosine use?

      Your Answer: Severe COPD

      Correct Answer: History of heart transplant

      Explanation:

      The purine nucleoside adenosine is used to diagnose and treat paroxysmal supraventricular tachycardia. Adenosine works by stimulating A1-adenosine receptors and opening potassium channels that are sensitive to acetylcholine. This causes the atrioventricular (AV) node’s cell membrane to become hyperpolarized, slowing conduction by inhibiting calcium channels.Patients who have had a heart transplant are extremely sensitive to the effects of adenosine and should start with a lower dose of 3 mg, then 6 mg, and finally 12 mg. Dipyridamole potentiates the effects of adenosine, so it should be used with caution in patients who are taking it.The use of adenosine is contraindicated in the following situations:AsthmaCOPD (chronic obstructive pulmonary disease)Decompensated heart failure Long QT syndromeAV block in the second or third degreeSinusitis is a condition in which the sinuses become (unless pacemaker fitted)Hypotension that is severeIt has a half-life of less than 10 seconds and acts quickly within that time frame. The actions last between 10 and 20 seconds. Because of the short half-life of the drug, any side effects are usually only temporary. These are some of them:a feeling of impending doomFlushing of the faceDyspnoeaUncomfortable chestTastes metallic

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      25.1
      Seconds
  • Question 24 - Which of the following best describes digoxin: ...

    Correct

    • Which of the following best describes digoxin:

      Your Answer: A positive inotrope and negative chronotrope

      Explanation:

      Digoxin is a cardiac glycoside used in the treatment of atrial fibrillation and flutter, and congestive cardiac failure. It acts by inhibiting the membrane Na/K ATPase in cardiac myocytes. This raises intracellular sodium concentration and increases intracellular calcium availability indirectly via Na/Ca exchange. The increase in intracellular calcium levels causes an increases the force of myocardial contraction (positive inotrope), and slows the heart rate (negative chronotrope).

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      8.6
      Seconds
  • Question 25 - A patient suffers an injury to the nerve that innervates gluteus medius.​The gluteus...

    Correct

    • A patient suffers an injury to the nerve that innervates gluteus medius.​The gluteus medius muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: Superior gluteal nerve

      Explanation:

      Gluteus minimus is innervated by the superior gluteal nerve.Gluteus medius is innervated by the superior gluteal nerve.Gluteus maximus is innervated by the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      4.7
      Seconds
  • Question 26 - Regarding calcium handling by the kidneys, which of the following statements is CORRECT:...

    Correct

    • Regarding calcium handling by the kidneys, which of the following statements is CORRECT:

      Your Answer: Activated vitamin D upregulates Ca 2+ ATPase pumps in the distal tubule.

      Explanation:

      Calcium that is not protein bound is freely filtered in the glomerulus, and there is reabsorption along the nephron.About 70% is reabsorbed in the proximal tubule.About 20% is reabsorbed in the thick ascending limb of the loop of Henle.This reabsorption is mainly passive and paracellular and driven by sodium reabsorption. Sodium reabsorption causes water reabsorption, which raises tubular calcium concentration, causing calcium to diffuse out of the tubules. The positive  lumen potential also encourages calcium to leave the tubule.About 5 – 10% is reabsorbed in the distal convoluted tubule.Less than 0.5% is reabsorbed in the collecting ducts.Calcium reabsorption in the distal nephron is active and transcellular and is the major target for hormonal control.Calcium homeostasis is primarily controlled by three hormones: parathyroid hormone, activated vitamin D and calcitonin.Parathyroid hormone acts on the kidneys to increase calcium reabsorption in the distal tubule by activating Ca2+entry channels in the apical membrane and the Ca2+ATPase pump in the basolateral membrane (and to decrease phosphate reabsorption in the proximal tubule).Activated vitamin D acts to increase calcium reabsorption in the distal tubule via activation of a basolateral Ca2+ATPase pump (and to increase phosphate reabsorption).Calcitonin acts to inhibit renal reabsorption of calcium (and phosphate).

    • This question is part of the following fields:

      • Physiology
      • Renal
      13.1
      Seconds
  • Question 27 - A 22-year-old man arrives at the emergency department with a sore throat, low-grade...

    Correct

    • A 22-year-old man arrives at the emergency department with a sore throat, low-grade fever, and malaise. His partner has infectious mononucleosis, which was recently diagnosed. In this situation, which of the following cells is the most proliferative:

      Your Answer: Lymphocytes

      Explanation:

      Histologic findings in EBV infectious mononucleosis: Oropharyngeal epithelium demonstrates an intense lymphoproliferative response in the cells of the oropharynx. The lymph nodes and spleen show lymphocytic infiltration primarily in the periphery of a lymph node.Relative lymphocytosis (≥ 60%) plus atypical lymphocytosis (≥ 10%) are the characteristic findings of Epstein Barr virus (EBV) infectious mononucleosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      12
      Seconds
  • Question 28 - You are taking care of a 55-year-old male patient with a direct inguinal...

    Incorrect

    • You are taking care of a 55-year-old male patient with a direct inguinal hernia. In explaining his hernia, which of the following layers was compromised and had resulted in his condition?

      Your Answer: Internal oblique muscle

      Correct Answer: Transversalis fascia

      Explanation:

      Direct inguinal hernias are most often caused by a weakness in the muscles of the abdominal wall that develops over time, or are due to straining or heavy lifting. A direct inguinal hernia protrudes through the Transversalis fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      17.2
      Seconds
  • Question 29 - A 22 year old professional athlete sustains an inversion injury to her left...

    Correct

    • A 22 year old professional athlete sustains an inversion injury to her left ankle during the 800m. Which of the following ligaments is most likely injured:

      Your Answer: Anterior talofibular ligament

      Explanation:

      Inversion injuries at the ankle in plantarflexion (such as when wearing high heels) are common, and typically result in damage to the lateral collateral ligament of the ankle, made up of the anterior talofibular, the calcaneofibular and the posterior talofibular ligaments. The anterior talofibular and the calcaneofibular ligaments are most commonly injured, and the posterior talofibular ligament rarely. The spring ligament supports the head of the talus, the deltoid ligament supports the medial aspect of the ankle joint, and the long and short plantar ligaments are involved in maintaining the lateral longitudinal arch of the foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      14.9
      Seconds
  • Question 30 - In the small intestine, there is a deep gap between each villus that...

    Correct

    • 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 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.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      7.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pharmacology (6/8) 75%
Respiratory (1/3) 33%
Immunological Products & Vaccines (1/1) 100%
Anaesthesia (1/1) 100%
Anatomy (6/10) 60%
Cranial Nerve Lesions (1/1) 100%
Haematology (1/1) 100%
Pathology (2/2) 100%
Upper Limb (1/2) 50%
Physiology (6/9) 67%
Cardiovascular (3/3) 100%
Fluids And Electrolytes (1/1) 100%
Endocrine (1/2) 50%
Central Nervous System (0/1) 0%
Lower Limb (3/3) 100%
Respiratory Physiology (1/1) 100%
Renal Physiology (1/2) 50%
Microbiology (1/1) 100%
Specific Pathogen Groups (1/1) 100%
Thorax (1/2) 50%
Cardiovascular Pharmacology (0/1) 0%
Renal (1/1) 100%
Immune Responses (1/1) 100%
Abdomen (0/1) 0%
Gastrointestinal Physiology (1/1) 100%
Passmed