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

    Correct

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

      Your Answer: Ampicillin may cause a widespread maculopapular rash in a patient with glandular fever.

      Explanation:

      Ampicillin is a broad-spectrum antibiotic, active against certain Gram-positive and Gram-negative organisms but is inactivated by penicillinases (similar to amoxicillin in spectrum). Ampicillin is associated with high levels of resistance, therefore it is often not appropriate for blind treatment of infection. It is principally indicated for the treatment of exacerbations of chronic bronchitis and middle ear infections, both of which may be due to Streptococcus pneumoniae and H. influenzae, and for urinary tract infections. Maculopapular rashes commonly occur with ampicillin (and amoxicillin) but are not usually related to true penicillin allergy. They almost always occur in patients with glandular fever; thus broad-spectrum penicillins should not be used for blind treatment of a sore throat. The risk of rash is also increased in patients with acute or chronic lymphocytic leukaemia or in cytomegalovirus infection.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      132.7
      Seconds
  • Question 2 - A 66-year-old female presents to the Emergency Department with a nose bleed. She...

    Incorrect

    • A 66-year-old female presents to the Emergency Department with a nose bleed. She says that she has been having frequent episodes of nose bleeds over the past four months, along with increasing fatigue and some weight loss. On examination, she has a diffuse petechial rash and hypertrophy of the gingiva. Which one of the following conditions is this patient most likely to have?

      Your Answer: Acute lymphocytic leukaemia (ALL)

      Correct Answer: Acute myeloid leukaemia (AML)

      Explanation:

      The history of nosebleeds and fatigue, and gingival hyperplasia presents a typical picture of acute myeloid leukaemia. Leukemic infiltrates within the gingiva cause hypertrophy and distinguish this condition from other types of leukaemia. The fatigue is secondary to anaemia, while the nosebleeds are caused by thrombocytopenia secondary to leukemic infiltration of bone marrow. Patients may also report frequent infections secondary to neutropenia and hepatosplenomegaly.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      5.3
      Seconds
  • Question 3 - Aside from the inability to extend the leg above the knee, which of...

    Incorrect

    • Aside from the inability to extend the leg above the knee, which of the following clinical symptoms should you anticipate seeing in a patient who had a pelvic and right leg injury as well as femoral nerve damage?

      Your Answer: Weak extension of the thigh at the hip

      Correct Answer: Loss of sensation over the anterior thigh

      Explanation:

      The femoral nerve runs down the front of the leg from the pelvis. It gives the front of the thigh and a portion of the lower leg sensation. Extension of the leg at the knee joint, flexion of the thigh at the hip are produced by muscles that is primarily innervated by the femoral nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      16.5
      Seconds
  • Question 4 - Which of the following anatomic structures will gallstones most likely lodge into, and...

    Correct

    • Which of the following anatomic structures will gallstones most likely lodge into, and cause cholestasis?

      Your Answer: Hartmann’s pouch

      Explanation:

      Hartmann’s pouch is a diverticulum that can occur at the neck of the gallbladder. It is one of the rarest congenital anomalies of the gallbladder. Hartmann’s gallbladder pouch is a frequent but inconsistent feature of normal and pathologic human gallbladders. It is caused by adhesions between the cystic duct and the neck of the gallbladder. As a result, it is classified as a morphologic rather than an anatomic entity.There is a significant association between the presence of Hartmann’s pouch and gallbladder stones. It is the most common location for gallstones to become lodged and cause cholestasis.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      1.5
      Seconds
  • Question 5 - A young patient presents with the features of an easily recognisable infectious disease.Which...

    Correct

    • A young patient presents with the features of an easily recognisable infectious disease.Which of the following infectious diseases typically has an incubation period of less than 1 week? Select ONE answer only.

      Your Answer: Cholera

      Explanation:

      Cholera has an incubation period of 12 hours to 6 days.Other infectious disease that have an incubation period of less than 1 week include:Staphylococcal enteritis (1-6 hours)Salmonella enteritis (12-24 hours)Botulism (18-36 hours)Gas gangrene (6 hours to 4 days)Scarlet fever (1-4 days)Diphtheria (2-5 days)Gonorrhoea (3-5 days)Yellow fever (3-6 days)Meningococcaemia (1-7 days)Brucellosis has an incubation period of 7-21 days.Measles has an incubation period of 14-18 days.Falciparum malaria usually has an incubation period of 7-14 days. The other forms of malaria have a longer incubation period of 12-40 days.Rubella has an incubation period of 14-21 days.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      1560.9
      Seconds
  • Question 6 - How is filtered K+mainly reabsorbed in the thick ascending limb of the loop...

    Incorrect

    • How is filtered K+mainly reabsorbed in the thick ascending limb of the loop of Henle:

      Your Answer: Primary active transport via K + /H + ATPase

      Correct Answer: Secondary active transport via Na + /K + /2Cl - cotransporter

      Explanation:

      Around 30% of filtered K+is reabsorbed in the thick ascending limb of the loop of Henle, primarily via the luminal Na+/K+/2Cl-cotransporter, but there is also significant paracellular reabsorption, encouraged by the positive potential in the tubular lumen.

    • This question is part of the following fields:

      • Physiology
      • Renal
      10.9
      Seconds
  • Question 7 - You examine a 73-year-old patient who is experiencing a worsening of his chronic...

    Incorrect

    • You examine a 73-year-old patient who is experiencing a worsening of his chronic heart failure. Bumetanide was recently prescribed for him.Which of the following statements about bumetanide is correct?

      Your Answer: It is approximately 10 times more potent than furosemide

      Correct Answer: It has better intestinal absorption than furosemide

      Explanation:

      Bumetanide is a loop diuretic that inhibits sodium, chloride, and potassium reabsorption by acting on the Na.K.2Cl co-transporter in the ascending loop of Henlé. This reduces the osmotic gradient that forces water out of the collecting duct system and prevents the formation of a hypertonic renal medulla. This has a strong diuretic effect on the body.It’s primarily used in patients with heart failure who aren’t responding 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%. Bumetanide is 40 times more potent than furosemide, and one milligram is roughly equivalent to 40 milligrams of furosemide.Bumetanide also lowers the concentration of neuronal chloride, making GABA’s action more depolarizing. In the neonatal period, it is being studied as an antiepileptic.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      14.6
      Seconds
  • Question 8 - C5 - C9 deficiency increases susceptibility to infection with which of the following:...

    Incorrect

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

      Your Answer: Intracellular bacteria

      Correct Answer: Neisseria spp.

      Explanation:

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

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      6.7
      Seconds
  • Question 9 - A 5-year-old girl is brought into the Paediatric ER for acute seizures. She...

    Correct

    • A 5-year-old girl is brought into the Paediatric ER for acute seizures. She has been convulsing for the past 18 minutes now and was already two doses of lorazepam in the ambulance. Now, you prepare a phenytoin infusion to abolish the seizures. According to the APLS algorithm, what dose of phenytoin is advised for a convulsing child at this stage?

      Your Answer: 20 mg/kg over 20 minutes

      Explanation:

      Advanced paediatric life support (APLS) recommends phenytoin as the first choice for second-line anticonvulsant in a patient that continues to seize ten minutes after the second dose of the first-line anticonvulsant (benzodiazepine). (step 3 of the APLS algorithm)The recommended dose of phenytoin infusion is up at 20 mg/kg over 20 minutes. If the patient has already taken phenytoin as maintenance therapy or is allergic to phenytoin, then a phenobarbitone infusion should be set up at 20 mg/kg over 30-60 minutes.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      12.1
      Seconds
  • Question 10 - You're called to a cardiac arrest in your Emergency Department resuscitation area. The...

    Correct

    • You're called to a cardiac arrest in your Emergency Department resuscitation area. The rhythm strip is shown in the diagram below. Defibrillation has already been attempted three times on the patient. You intended to administer amiodarone, but your department has informed you that it is not available.In these circumstances, if amiodarone is not available, which of the following drugs is recommended by the ALS guidelines?

      Your Answer: Lidocaine

      Explanation:

      If amiodarone is unavailable in VF/pVT arrests, lidocaine at a dose of 1 mg/kg can be used instead, according to the latest ALS guidelines. If amiodarone has already been given, no lidocaine should be given.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      55.1
      Seconds
  • Question 11 - You examine a 50-year-old female who has a swollen, painful right big toe. She...

    Incorrect

    • You examine a 50-year-old female who has a swollen, painful right big toe. She has a history of gout, and this discomfort is identical to prior relapses, according to her. She is currently taking 200 mg of allopurinol per day and has been for the last year. This is her second round of acute gout within this time period. She has no prior medical history to speak of and does not take any other medications. She doesn't have any known drug allergies.Which of the following management options is the SINGLE MOST APPROPRIATE? 

      Your Answer: Stop the allopurinol and commence naproxen

      Correct Answer: Continue with the allopurinol and commence naproxen

      Explanation:

      Allopurinol should not be started during an acute gout episode because it can both prolong and trigger another acute attack. Allopurinol should be continued in patients who are currently taking it, and acute attacks should be treated as usual with NSAIDs or colchicine, as needed.Non-steroidal anti-inflammatory medications (NSAIDs), such as naproxen, are the first-line treatment for acute gout attacks. Colchicine can be used in situations where NSAIDs are contraindicated, such as in patients with hypertension or those who have had a history of peptic ulcer disease. Because there is no reason for this patient to avoid NSAIDs, naproxen would be the medicine of choice from the list above.It would be reasonable to titrate up the allopurinol dose once the acute episode has subsided, targeting <6 mg/dl (<360 µmol/l) plasma urate levels .Febuxostat (Uloric) is a drug that can be used instead of allopurinol to treat persistent gout.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      154.2
      Seconds
  • Question 12 - Which of the following is NOT a common side effect of adenosine: ...

    Correct

    • Which of the following is NOT a common side effect of adenosine:

      Your Answer: Yellow vision

      Explanation:

      Common side effects of adenosine include:ApprehensionDizziness, flushing, headache, nausea, dyspnoeaAngina (discontinue)AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      3.9
      Seconds
  • Question 13 - Capillaries are designed with a small diffusion distance for nutrition and gaseous exchange...

    Correct

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

      Your Answer: Continuous capillaries

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      61.4
      Seconds
  • Question 14 - Regarding apoptosis, which of the following statements is INCORRECT: ...

    Correct

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

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

      Explanation:

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

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      5.2
      Seconds
  • Question 15 - Which of the following body location is the appropriate site to apply pressure...

    Incorrect

    • Which of the following body location is the appropriate site to apply pressure when performing a carotid sinus massage?

      Your Answer: Cricoid cartilage

      Correct Answer: Thyroid cartilage

      Explanation:

      The common carotid artery runs through the neck and divides into internal and external carotid arteries on both sides near the upper thyroid cartilage. In emergency situations, carotid sinus massage is also used to diagnose or treat paroxysmal supraventricular tachycardia. During the procedure, to maximize access to the carotid artery, the patient is put in a supine position with the neck extended (i.e. elevating the chin away from the chest). The carotid sinus is normally positioned inferior to the angle of the jaw, near the arterial impulse, at the level of the thyroid cartilage. For 5 to 10 seconds, pressure is administered to one carotid sinus. Although pulsatile pressure applied in a vigorous circular motion may be more effective, continuous pressure is preferred since it is more reproducible. If the predicted reaction is not obtained, the operation is repeated on the opposite side after a one- to two-minute wait.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      14.3
      Seconds
  • Question 16 - A dermatological examination of a patient presenting with a lump shows a visible...

    Incorrect

    • A dermatological examination of a patient presenting with a lump shows a visible collection of fluid measuring 0.3 cm in diameter.Which one of these best describes the lump you have found on examination?

      Your Answer: Pustule

      Correct Answer: Vesicle

      Explanation:

      A vesicle is a visible collection of fluid measuring less than 0.5 cm in diameter.A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus. A carbuncle is a collection of individual boils clustered together. A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter. A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      17.4
      Seconds
  • Question 17 - A 30-year-old man bought into the ED with increased thirst, confusion, abdominal pain...

    Correct

    • A 30-year-old man bought into the ED with increased thirst, confusion, abdominal pain and constipation is suspected to have hypercalcaemia.What is the commonest cause of hypercalcaemia in the UK?

      Your Answer: Primary hyperparathyroidism

      Explanation:

      The commonest cause of hypercalcaemia in the UK is primary hyperparathyroidism, which accounts for around 70-80% of cases. It is commoner in younger patients and in community setting.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      13.4
      Seconds
  • Question 18 - A 20-year-old male has an anaphylactic reaction following a wasp sting.What type of...

    Correct

    • A 20-year-old male has an anaphylactic reaction following a wasp sting.What type of hypersensitivity reaction is this?

      Your Answer: Type I

      Explanation:

      Anaphylaxis is an example of a type I hypersensitivity reaction. It is IgE mediated. It requires a prior exposure to the antigen. The initial exposure sensitizes the body to the antigen and a second exposure to that antigen leads to an anaphylactic reaction.Massive calcium influx into the cells leads to mast cell degranulation. The Immunoglobulin antigen complex binds to Fc receptors on the surface of mast cells. The result is mast cell degranulation and release of histamine, proteoglycans and serum proteases from cytoplasmic granules.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      9.5
      Seconds
  • Question 19 - Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or...

    Incorrect

    • Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or rectosigmoid should be treated initially with:

      Your Answer: Oral aminosalicylate

      Correct Answer: Local aminosalicylate

      Explanation:

      Acute mild to moderate disease affecting the rectum (proctitis) or the rectosigmoid is treated initially with local application of an aminosalicylate; alternatively, a local corticosteroid can be used but it is less effective. A combination of a local aminosalicylate and a local corticosteroid can be used for proctitis that does not respond to a local aminosalicylate alone.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      13.2
      Seconds
  • Question 20 - Regarding T helper cells, which of the following statements is CORRECT: ...

    Correct

    • Regarding T helper cells, which of the following statements is CORRECT:

      Your Answer: They form the vast majority (about 75%) of the total circulating T-cell population.

      Explanation:

      CD4+ T-cells (Helper T cells)Recognise antigen only in association with HLA class II molecules (found on antigen presenting cells (APCs) e.g. dendritic cells, B-cells; present exogenous antigens that have been phagocytosed/endocytosed into intracellular vesicles)Form most of the circulating T-cell population (about 75%)Secrete cytokines (e.g. IFN-gamma) which are required for recruitment and activation of other immune cells such as macrophages, T cytotoxic cells and NK cells and for the activation of and production of immunoglobulin from B-cells

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      17.3
      Seconds
  • Question 21 - A 63-year-old man presents with severe abdominal pain and vomiting of blood. An...

    Correct

    • A 63-year-old man presents with severe abdominal pain and vomiting of blood. An endoscopy was performed and a peptic ulcer was found to have eroded into an artery nearby.Which of the following most likely describes the location of the ulcer?

      Your Answer: The posterior duodenum

      Explanation:

      The most common cause of upper gastrointestinal bleeding is peptic ulcer disease, particularly gastric and duodenal ulcers. Duodenal ulcers are most commonly associated with bleeding compared with gastric ulcers. Posterior duodenal ulcers are considered to be the most likely to cause severe bleeding because of its proximity to the branches of the gastroduodenal artery (GDA).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      7.5
      Seconds
  • Question 22 - A 7-year old boy is referred to the Paediatrics Department due to slurred...

    Correct

    • A 7-year old boy is referred to the Paediatrics Department due to slurred speech. Upon further examination, the attending physician noted the presence of dysdiadochokinesia, intention tremors, and nystagmus. An MRI is taken, which revealed a brain tumour.Which of the following options is the most probable diagnosis given the clinical features of the patient?

      Your Answer: Astrocytoma of cerebellum

      Explanation:

      Pilocytic astrocytoma (PCA), previously known as cystic cerebellar astrocytoma or juvenile pilocytic astrocytoma, was first described in 1931 by Harvey Cushing, based on a case series of cerebellar astrocytomas; though he never used these terms but rather described a spongioblastoma. They are low-grade, and usually well-circumscribed tumours, which tend to occur in young patients. By the World Health Organization (WHO) classification of central nervous system tumours, they are considered grade I gliomas and have a good prognosis.PCA most commonly occurs in the cerebellum but can also occur in the optic pathway, hypothalamus, and brainstem. They can also occur in the cerebral hemispheres, although this tends to be the case in young adults. Presentation and treatment vary for PCA in other locations. Glial cells include astrocytes, oligodendrocytes, ependymal cells, and microglia. Astrocytic tumours arise from astrocytes and are the most common tumour of glial origin. The WHO 2016 categorized these tumours as either diffuse gliomas or other astrocytic tumours. Diffuse gliomas include grade II and III diffuse astrocytomas, grade IV glioblastoma, and diffuse gliomas of childhood. The other astrocytic tumours group include PCA, pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, and anaplastic pleomorphic xanthoastrocytoma.PCA can present with symptoms secondary to the posterior fossa mass effect. This may include obstructive hydrocephalus, with resultant headache, nausea and vomiting, and papilledema. If hydrocephalus occurs before the fusion of the cranial sutures (<18-months-of-age), then an increase in head circumference will likely occur. Lesions of the cerebellar hemisphere result in peripheral ataxia, dysmetria, intention tremor, nystagmus, and dysarthria. In contrast, lesions of the vermis cause a broad-based gait, truncal ataxia, and titubation. Posterior fossa lesions can also cause cranial nerve palsies. Diplopia may occur due to abducens palsy from the stretching of the nerve. They may also have blurred vision due to papilledema. Seizures are rare with posterior fossa lesions.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      6.5
      Seconds
  • Question 23 - A 79-year-old male had a humeral shaft fracture during a road traffic accident...

    Correct

    • A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.All the following are responsible for this non-union EXCEPT?

      Your Answer: Osteoporosis

      Explanation:

      An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected. Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      162
      Seconds
  • Question 24 - A 7-days-old neonate is taken to the emergency department. She's pyretic, lethargic, and unresponsive, and...

    Incorrect

    • A 7-days-old neonate is taken to the emergency department. She's pyretic, lethargic, and unresponsive, and her fontanelle has bulged.  Antibiotics are started, and a lumbar puncture reveals Gram-negative rods. Which pathogen is most likely to be the cause:

      Your Answer: Group B streptococcus (GBS)

      Correct Answer: Escherichia coli

      Explanation:

      Among neonates, group B streptococci (GBS) are the most commonly identified causes of bacterial meningitis, implicated in roughly 50% of all cases. Escherichia coli(Gram-negative rods) accounts for another 20%. Thus, the identification and treatment of maternal genitourinary infections is an important prevention strategy.

    • This question is part of the following fields:

      • Infections
      • Microbiology
      18.8
      Seconds
  • Question 25 - You examine a 48-year-old patient who has had proximal weakness, hypertension, and easy...

    Incorrect

    • You examine a 48-year-old patient who has had proximal weakness, hypertension, and easy bruising in the past. She exhibits considerable face fullness and truncal obesity on examination. You diagnose her with Cushing's syndrome.When would her random cortisol level likely be abnormal? 

      Your Answer: 0900 hrs

      Correct Answer: 2400 hrs

      Explanation:

      Cortisol levels fluctuate throughout the day, with the greatest levels occurring around 0900 hours and the lowest occurring at 2400 hrs during sleep.The diurnal swing of cortisol levels is lost in Cushing’s syndrome, and levels are greater throughout the 24-hour period. In the morning, levels may be normal, but they may be high at night-time, when they are generally repressed.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      15.6
      Seconds
  • Question 26 - A 40-year-old woman presents with a red, scaly, itchy rash around her navel...

    Correct

    • A 40-year-old woman presents with a red, scaly, itchy rash around her navel that occurred after contact with a nickel belt buckle. A diagnosis of allergic contact dermatitis is made.Which type of hypersensitivity reaction is this?

      Your Answer: Type IV hypersensitivity reaction

      Explanation:

      A type IV hypersensitivity reaction occurred in this patient. Allergic contact dermatitis is an inflammatory skin reaction occurring in response to an external stimulus, acting either as an allergen or an irritant, caused by a type IV or delayed hypersensitivity reaction. They usually take several days to develop.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5.7
      Seconds
  • Question 27 - A tumour compresses the jugular foramen of a 50-year-old patient. Compression of several...

    Correct

    • A tumour compresses the jugular foramen of a 50-year-old patient. Compression of several nerves in the jugular foramen will result in which of the following complications?

      Your Answer: Loss of gag reflex

      Explanation:

      The glossopharyngeal nerve, which is responsible for the afferent pathway of the gag reflex, the vagus nerve, which is responsible for the efferent pathway of the gag reflex, and the spinal accessory nerve all exit the skull through the jugular foramen. These nerves are most frequently affected if the jugular foramen is compressed. As a result, the patient’s gag reflex is impaired. The vestibulocochlear nerve is primarily responsible for hearing. The trigeminal nerve provides sensation in the face. The facial nerve innervates the muscles of face expression (including those responsible for closing the eye). Tongue motions are controlled mostly by the hypoglossal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      6.1
      Seconds
  • Question 28 - Regarding V/Q mismatch, which of the following statements is CORRECT: ...

    Correct

    • Regarding V/Q mismatch, which of the following statements is CORRECT:

      Your Answer: In a true shunt, increasing inspired oxygen has no effect on improving hypoxaemia.

      Explanation:

      Both ventilation and perfusion increase towards the lung base, because of the effects of gravity, but the gravitational effects are greater on perfusion than ventilation and therefore there is a regional variation in V/Q ratio from lung apex (high V/Q) to lung base (low V/Q). In a pure shunt, there is normal perfusion but absent ventilation and the V/Q ratio = 0. In a true shunt increasing oxygen fraction has no effect because the oxygen-enriched air fails to reach the shunted blood. An increased A-a gradient is seen in V/Q mismatch.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      8.7
      Seconds
  • Question 29 - 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
      11.6
      Seconds
  • Question 30 - A 32-year-old woman suffers a deep wound to her thigh while she was...

    Correct

    • A 32-year-old woman suffers a deep wound to her thigh while she was climbing over a barbed wire fence. As a consequence of her injury, the nerve that was severed innervates the gracilis muscle.In which of the following nerves is the gracilis muscle innervated by?

      Your Answer: Anterior branch of the obturator nerve

      Explanation:

      The gracilis muscles is innervated by the anterior branch of the obturator nerve (L2-L4).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      131.6
      Seconds

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