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  • Question 1 - Aldin is a 24-year-old male patient who arrives at the emergency department diagnosed...

    Correct

    • Aldin is a 24-year-old male patient who arrives at the emergency department diagnosed with psittacosis based on his symptoms and history of being a pigeon enthusiast. Which of the following is the causative bacteria of psittacosis?

      Your Answer: Chlamydia psittaci

      Explanation:

      Chlamydia psittaci is a microorganism that is commonly found in birds. These bacteria can infect people and cause psittacosis. Psittacosis is an infectious disease that may cause high fever and pneumonia associated with headaches, altered mental state, and hepatosplenomegaly.

    • This question is part of the following fields:

      • Infections
      • Microbiology
      7.4
      Seconds
  • Question 2 - A 49-year-old woman with haemoglobin of 6 g/dL following persistent vaginal bleeding receives...

    Correct

    • A 49-year-old woman with haemoglobin of 6 g/dL following persistent vaginal bleeding receives blood transfusion. She developed pain and burning at her cannula site and complains of a feeling of “impending doom”, nausea, and severe back pain shortly after transfusion was started. Her temperature is 38.9ºC.What is the most appropriate treatment?

      Your Answer: Stop the transfusion and administer IV fluids

      Explanation:

      Acute haemolytic transfusion reactions present with: Feeling of ‘impending doom’ as the earliest symptom, fever and chills, pain and warmth at transfusion site, nausea and vomiting, back, joint, and chest pain. Transfusion should be stopped immediately and IV fluid (usually normal saline) administered.Supportive measures and paracetamol can be given since patient has fever but it is not the immediate first step.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      38.7
      Seconds
  • Question 3 - You examine a 72-year-old man who has recently begun bumetanide treatment for worsening...

    Incorrect

    • You examine a 72-year-old man who has recently begun bumetanide treatment for worsening heart failure.Which of these statements about bumetanide is correct?

      Your Answer: It is 10 times more potent than furosemide

      Correct Answer: It has better intestinal absorption than furosemide

      Explanation:

      Bumetanide is a loop diuretic that is used to treat congestive heart failure. It is frequently used in patients who have failed to respond to high doses of furosemide.It has a potency of about 40 times that of furosemide, with a 1 mg dose being roughly equivalent to a 40 mg dose of furosemide.Seizures are not known to be triggered by bumetanide. In fact, it lowers the concentration of neuronal chloride, making GABA’s action more depolarizing, and it’s currently being tested as an antiepileptic in the neonatal period.It takes effect after 1 hour of oral administration, and diuresis takes 6 hours to complete.Bumetanide absorbs much better in the intestine than furosemide. Because it has a higher bioavailability than furosemide, it is commonly used in patients with gut oedema.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      10
      Seconds
  • Question 4 - A 29-year-old woman presents with night sweats, fever, and haemoptysis. A diagnosis of...

    Incorrect

    • A 29-year-old woman presents with night sweats, fever, and haemoptysis. A diagnosis of tuberculosis was suspected.Which of the following statements regarding the diagnosis of tuberculosis is considered correct?

      Your Answer: Mycobacteria tuberculosis appears blue on acid-fast staining

      Correct Answer: Mycobacteria tuberculosis can be typed using a RFLP method

      Explanation:

      Although a variety of clinical specimens may be submitted to thelaboratory to recover MTB and NTM, respiratory secretions suchas sputum and bronchial aspirates are the most common. Anearly-morning specimen should be collected on three consecutivedays, although recent studies have suggested that the addition ofa third specimen does not significantly increase the sensitivityof detecting Mycobacteria.Mycobacterium tuberculosis appear red on acid-fast staining because they take up the primary stain, which is carbolfuchsin, and is not decolorized by the acid alcohol anymore.Culture on Lowenstein-Jensen medium should be read within 5 to 7 days after inoculation and once a week thereafter for up to 8 weeks.Nucleic acid amplification assays designed to detect M. tuberculosis complexbacilli directly from patient specimens can be performed in as little as 6 to 8 hours on processed specimens.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      13.2
      Seconds
  • Question 5 - Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is...

    Incorrect

    • Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is responsible for 20% of all leukemias.Which of the following statements about CML is NOT TRUE?

      Your Answer: There is typically a low neutrophil alkaline phosphatase score

      Correct Answer: Serum B12 is typically low

      Explanation:

      Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is responsible for 20% of all leukemias. The majority of CML patients experience fatigue, weight loss, and excessive sweating.The Philadelphia chromosome is found in over 90% of CML cases. A balanced translocation between chromosomes 9 and 22 is known as the Philadelphia chromosome.Because white cells produce a B12 binding protein, serum B12 levels in CML are typically high.In CML, the neutrophil alkaline phosphatase score is usually low.Almost all patients with CML eventually progress to blast crisis, though this can take up to ten years. If any of the following features are present in a CML patient, a blast crisis is diagnosed:In the blood or bone marrow, there are more than 20% myeloblasts or lymphoblasts.On a bone marrow biopsy, large clusters of blasts were discovered.CML can be treated with tyrosine kinase inhibitors like imatinib and dasatinib if a chloroma (a solid tumour made up of myeloblasts that grows outside of the bone marrow) is present.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      21.7
      Seconds
  • Question 6 - Which lobe of the prostate gland is most commonly affected in benign prostatic...

    Incorrect

    • Which lobe of the prostate gland is most commonly affected in benign prostatic hypertrophy?

      Your Answer: Posterior

      Correct Answer: Median

      Explanation:

      Benign enlargement of the prostate is common in men older than 50 years. The cause is possibly an imbalance in the hormonal control of the gland. The median lobe of the gland enlarges upward and encroaches within the sphincter vesicae, located at the neck of the bladder. The leakage of urine into the prostatic urethra causes an intense reflex desire to micturate. The enlargement of the median and lateral lobes of the gland produces elongation and lateral compression and distortion of the urethra so that the patient experiences difficulty in passing urine and the stream is weak. Back-pressure effects on the ureters and both kidneys are a common complication. The enlargement of the uvula vesicae (owing to the enlarged median lobe) results in the formation of a pouch of stagnant urine behind the urethral orifice within the bladder. The stagnant urine frequently becomes infected, and the inflamed bladder (cystitis) adds to the patient’s symptoms.In all operations on the prostate, the surgeon regards the prostatic venous plexus with respect. The veins have thin walls, are valveless, and are drained by several large trunks directly into the internal iliac veins. Damage to these veins can result in a severe haemorrhage.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      6.8
      Seconds
  • Question 7 - Which of the following microbes is spread by a vector: ...

    Correct

    • Which of the following microbes is spread by a vector:

      Your Answer: Plasmodium falciparum

      Explanation:

      The female Anopheles mosquito is the vector for Plasmodium falciparum transmission. Treponema pallidum is transmitted through sexual transmission or direct skin contact. Clostridium perfringens is spread by direct skin contact or through oral-faecal route. The oral-faecal pathway is how Vibrio cholerae spreads. Mycoplasma tuberculosis is spread via the airborne route.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      5.9
      Seconds
  • Question 8 - External haemorrhoids may cause anal pain. When explaining to your patient why it...

    Correct

    • External haemorrhoids may cause anal pain. When explaining to your patient why it does so, which of the following nerves will you point out as being affected?

      Your Answer: Pudendal nerve

      Explanation:

      The pain associated with external haemorrhoids is carried by a branch of the pudendal nerve, specifically the somatic fibres (S2-S4). It innervates the external anal sphincter and most of the skin over the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      8.2
      Seconds
  • Question 9 - Regarding bile, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: Bile passes into the duodenum through the ampulla of Vater.

      Explanation:

      Bile is synthesised in the liver. Bile functions to eliminate endogenous and exogenous substances from the liver, to neutralise gastric acid in the small intestine, and to emulsify fats in the small intestine and facilitate their digestion and absorption. Bile is stored and concentrated in the gallbladder. Bile passes out of the gallbladder via the cystic duct. Bile passes into the duodenum through the ampulla of Vater regulated by the sphincter of Oddi.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      10
      Seconds
  • Question 10 - A blood test of a 7-year-old child with a 6-day history of bloody...

    Incorrect

    • 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: Campylobacter jejuni

      Correct 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
      12.7
      Seconds
  • Question 11 - The sensory innervation of the oropharynx is provided by which of the following...

    Correct

    • The sensory innervation of the oropharynx is provided by which of the following nerves:

      Your Answer: Glossopharyngeal nerve

      Explanation:

      Each subdivision of the pharynx has a different sensory innervation:the nasopharynx is innervated by the maxillary nervethe oropharynx is innervated by the glossopharyngeal nervethe laryngopharynx is innervated by the vagus nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      10
      Seconds
  • Question 12 - Regarding the lumbar plexus, which of the following is a direct muscular branch?...

    Correct

    • Regarding the lumbar plexus, which of the following is a direct muscular branch?

      Your Answer: Nerve to quadratus lumborum

      Explanation:

      The lumbar plexus gives rise to several branches which supply various muscles and regions of the posterior abdominal wall and lower limb. These branches include the Iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral and obturator nerves.In addition, the lumbar plexus gives off muscular branches from its roots, a branch to the lumbosacral trunk and occasionally an accessory obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      5.9
      Seconds
  • Question 13 - The lymph drainage of the anal canal above the pectinate line is initially...

    Correct

    • The lymph drainage of the anal canal above the pectinate line is initially to the:

      Your Answer: Internal iliac nodes

      Explanation:

      Above the pectinate line, the anal canal drains to the internal iliac lymph nodes which subsequently drain to the lumbar (para-aortic) nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      4.7
      Seconds
  • Question 14 - A 20-year-old boy took almost 25 tablets of paracetamol almost 4 hours ago....

    Incorrect

    • A 20-year-old boy took almost 25 tablets of paracetamol almost 4 hours ago. The boy is healthy and has no known comorbid or drug history. Out of the following metabolic pathways, which one is primarily responsible for the toxic effects of paracetamol?

      Your Answer: Glucuronidation

      Correct Answer: N-hydroxylation

      Explanation:

      Paracetamol is predominantly metabolized in the liver by three main metabolic pathways:1. Glucuronidation (45-55%)2. Sulphate conjugation (30-35%)3. N-hydroxylation via the hepatic cytochrome P450 enzyme system (10-15%)Cytochrome P450 enzymes catalyse the oxidation of acetaminophen to the reactive metabolite N-acetyl-p-benzoquinoneimine (NAPQI). NAPQI primarily contributes to the toxic effects of acetaminophen. NAPQI is an intermediate metabolite that is further metabolized by fast conjugation with glutathione. The conjugated metabolite is then excreted in the urine as mercapturic acid. High doses of acetaminophen (overdoses) can lead to hepatic necrosis due to depleting glutathione and high binding levels of reactive metabolite (NAPQI) to important parts of liver cells.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      13.9
      Seconds
  • Question 15 - A patient noticed ankle swelling and has passed very little urine over the...

    Correct

    • A patient noticed ankle swelling and has passed very little urine over the past 24 hours. He also has nausea and vomiting, reduced urine output and his blood results reveal a sudden rise in his creatinine levels over the past 48 hours. You make a diagnosis of acute kidney injury (AKI).Which one of these is a prerenal cause of AKI?

      Your Answer: Cardiac failure

      Explanation:

      The causes of AKI can be divided into pre-renal, intrinsic renal and post-renal causes. Majority of AKI developing in the community is due to a pre-renal causes (90% of cases).Pre-renal causes: Haemorrhage, severe vomiting or diarrhoea, burns, cardiac failure, liver cirrhosis, nephrotic syndrome, hypotension, severe cardiac failure, NSAIDs, COX-2 inhibitors, ACE inhibitors or ARBs, Abdominal aortic aneurysm, renal artery stenosis, hepatorenal syndrome, Intrinsic (renal) causes:Eclampsia, glomerulonephritis, thrombosis, haemolytic-uraemic syndrome, acute tubular necrosis (ATN), acute interstitial nephritis, drugs ( NSAIDs), infection or autoimmune diseases, vasculitis, polyarteritis nodosa, thrombotic microangiopathy, cholesterol emboli, renal vein thrombosis, malignant hypertensionPost-renal causes: Renal stones, Blood clot, Papillary necrosis, Urethral stricture, Prostatic hypertrophy or malignancy, Bladder tumour, Radiation fibrosis, Pelvic malignancy, Retroperitoneal fibrosis

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      13.1
      Seconds
  • Question 16 - A 24 year old male sustained an insect bite and presents with a...

    Correct

    • A 24 year old male sustained an insect bite and presents with a red hot arm and acute cellulitis has been diagnosed. The predominant white cells in this type of acute inflammation are:

      Your Answer: Neutrophils

      Explanation:

      Neutrophil polymorphs are the predominant type of white cells in an acute reaction. They pass between endothelial cell junctions to invade damaged tissue so that the effects of injury can be combated. Extravasation occurs with the movement of leukocytes out of the vessel lumen, and is achieved in five phases which are margination, ‘rolling’, adhesion, transmigration and chemotaxis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      4.7
      Seconds
  • Question 17 - A 35-year-old man suffers an open fracture of his forearm. The nerve that...

    Incorrect

    • A 35-year-old man suffers an open fracture of his forearm. The nerve that innervates the pronator quadratus muscle is damaged as a consequence of this injury.Which of the following nerves has been damaged in this case? Select ONE answer only.

      Your Answer: The radial nerve

      Correct Answer: The anterior interosseous nerve

      Explanation:

      Pronator quadratus is a small, square-shaped muscle that lies in the anterior compartment of the forearm. It arises from the distal fourth of the anterior surface of the ulna and inserts into the distal fourth of the anterior surface of the radius.Pronator quadratus is innervated by the anterior interosseous nerve. It receives its blood supply from the anterior interosseous artery, which is a branch of the common interosseous artery, which in turn is a branch of the ulnar artery.The main action of pronator quadratus is to assist pronator teres with pronation of the forearm. The deep fibres bind the radius and ulna together.The pronator quadratus muscle highlighted in blue (adapted from Gray’s Anatomy)

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.6
      Seconds
  • Question 18 - Which of these is NOT a lithium side effect: ...

    Incorrect

    • Which of these is NOT a lithium side effect:

      Your Answer: Tremor

      Correct Answer: Peptic ulcer disease

      Explanation:

      Adverse Effects of lithium IncludeLeucocytosis (most patients)Polyuria/polydipsia (30-50%)Dry mouth (20-50%)Hand tremor (45% initially, 10% after 1 year of treatment)Confusion (40%)Decreased memory (40%)Headache (40%)Muscle weakness (30% initially, 1% after 1 year of treatment)Electrocardiographic (ECG) changes (20-30%)Nausea, vomiting, diarrhoea (10-30% initially, 1-10% after 1-2 years of treatment)Hyperreflexia (15%)Muscle twitch (15%)Vertigo (15%)Extrapyramidal symptoms, goitre (5%)Hypothyroidism (1-4%)Acne (1%)Hair thinning (1%)

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      9.2
      Seconds
  • Question 19 - Regarding antihistamines, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Antihistamines act on H2 receptors.

      Correct Answer: Elderly patients and children are more susceptible to side effects.

      Explanation:

      Elderly patients and children are more susceptible to side effects. Antihistamines are competitive inhibitors at the H1-receptor. The newer antihistamines e.g. cetirizine cause less sedation and psychomotor impairment than the older antihistamines because they are much less lipid soluble and penetrate the blood brain barrier only to a slight extent. Antihistamines are used as a second line adjunct to adrenaline in anaphylaxis.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      14
      Seconds
  • Question 20 - A 68-year-old man has a very fast heartbeat' and is out of breath....

    Incorrect

    • A 68-year-old man has a very fast heartbeat' and is out of breath. He has had a heart transplant in the past. His electrocardiogram reveals supraventricular tachycardia.Which of the following is the most appropriate adenosine dose for him to receive as a first dose?

      Your Answer: Adenosine 6 mg IV

      Correct Answer: Adenosine 3 mg IV

      Explanation:

      A rapid IV bolus of adenosine is given, followed by a saline flush. The standard adult dose is 6 mg, followed by 12 mg if necessary, and then another 12 mg bolus every 1-2 minutes until an effect is seen.Patients who have had a heart transplant, on the other hand, 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.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      9.7
      Seconds
  • Question 21 - Regarding inhaled corticosteroids, which of the following statements is INCORRECT: ...

    Correct

    • Regarding inhaled corticosteroids, which of the following statements is INCORRECT:

      Your Answer: Lower doses of inhaled corticosteroids may be required in smokers.

      Explanation:

      Current and previous smoking reduces the effectiveness of inhaled corticosteroids and higher doses may be necessary.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      19.8
      Seconds
  • Question 22 - What is the appropriate dose of 1:1000 adrenaline solution for a 15-year-old patient...

    Correct

    • What is the appropriate dose of 1:1000 adrenaline solution for a 15-year-old patient with suspected anaphylactic shock?

      Your Answer: 500 micrograms intramuscularly

      Explanation:

      1: 1000 Adrenaline solution dosage for children above the age of 12 and adults, including pregnant women (over 50 kg) is 0.50 mL, which is equivalent to 500 mcg of adrenaline.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      5.5
      Seconds
  • Question 23 - 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
      7.4
      Seconds
  • Question 24 - What is the interquartile range for these numbers: 11, 4, 6, 8, 3,...

    Correct

    • What is the interquartile range for these numbers: 11, 4, 6, 8, 3, 10, 8, 10, 4, 12, 31?

      Your Answer: 7

      Explanation:

      We obtain 3, 4, 4, 6, 8, 8, 10, 11, 12, and 31, and sample size (n) = 11 when we order the data. [(n+1)/2] = median 6th value = (11+1)/2 = [(n+1)/4] represents the bottom (first) quartile. (3rd value = 4th value = (11 + 1)/4 3[(n+1)/4] for the top (third) quartile 3[(11 + 1)/4] = 9th value = 11th value = 11th value = 11th value = 11th value = 11th value = 11th value = 11th value = 11th The difference between the upper and lower quartiles is the interquartile range, which is equal to 11 minus 4 = 7.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      49.2
      Seconds
  • Question 25 - Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for: ...

    Correct

    • Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for:

      Your Answer: Hypocalcaemia

      Explanation:

      Common side effects of thiazide diuretics include:Excessive diuresis, postural hypotension, dehydration, renal impairmentAcid-base and electrolyte imbalanceHypokalaemia, hyponatraemia, hypomagnesaemia, hypercalcaemia, hypochloraemic alkalosisMetabolic imbalanceHyperuricaemia and goutImpaired glucose tolerance and hyperglycaemiaAltered plasma-lipid concentrationsMild gastrointestinal disturbances

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      10.5
      Seconds
  • Question 26 - Identify the type of graph described below:This graph has been used to create...

    Incorrect

    • Identify the type of graph described below:This graph has been used to create visual representations to communicate the risks and benefits of treatments using 4 face categories.

      Your Answer: Kaplan-Meier plot

      Correct Answer: Cates plot

      Explanation:

      Cates Plot, since 1999, has been used to create visual representations to communicate the risks and benefits of treatments. The essence of Cates Plot is the use of 4 face categories to visually indicate the following:People not affected by a treatment (green faces for those with a good outcome and red for those with a bad outcome)People for which treatment changes their category from a bad outcome to a good outcome (yellow faces)People for which treatment causes an adverse event and changes their category from a good outcome to a bad outcome (crossed out green faces)

    • This question is part of the following fields:

      • Evidence Based Medicine
      12.4
      Seconds
  • Question 27 - You intend to suture a hand wound with plain 1 percent lidocaine.In 1...

    Incorrect

    • You intend to suture a hand wound with plain 1 percent lidocaine.In 1 mL of plain 1 percent lidocaine solution, how much lidocaine hydrochloride is there?

      Your Answer: 100 mcg lidocaine hydrochloride

      Correct Answer: 10 mg lidocaine hydrochloride

      Explanation:

      10 mg of lidocaine hydrochloride is contained in each 1 mL of plain 1 percent lidocaine solution.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      30.1
      Seconds
  • Question 28 - A paediatric patient comes to the emergency room with complaints of right lower...

    Incorrect

    • A paediatric patient comes to the emergency room with complaints of right lower quadrant pain. The attending physician is considering appendicitis. Inside the operating room, the surgeon asks the medical student to locate the McBurney's point prior to the first incision.Which of the following is the surface anatomy of the McBurney's point?

      Your Answer: Two-thirds of the distance from the anterior superior iliac spine to the umbilicus

      Correct Answer: One-third of the distance from the anterior superior iliac spine to the umbilicus

      Explanation:

      Inflammation of the appendix is a significant public health problem with a lifetime incidence of 8.6% in men and 6.7% in women, with the highest incidence occurring in the second and third decade of life. While the rate of appendectomy in developed countries has decreased over the last several decades, it remains one of the most frequent emergent abdominal operations. Appendicitis can often result in anorexia, nausea, vomiting, and fever.McBurney’s point, which is found one-third of the distance between the anterior superior iliac spine and the umbilicus, is often the point of maximal tenderness in a patient with an anatomically normal appendix. A McBurney’s incision is chiefly used for cecostomy and appendectomy. It gives a limited exposure only, and should any doubt arise about the diagnosis, an infraumbilical right paramedian incision should be used instead.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      15.9
      Seconds
  • Question 29 - 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
      12.3
      Seconds
  • Question 30 - A 35-year-old man, who was feeling unwell after his return from a business...

    Correct

    • A 35-year-old man, who was feeling unwell after his return from a business trip, was diagnosed with a disease that is known to be transmitted by a vector. Among the following microorganisms, which of the following has a mode of transmission of being vector-borne?

      Your Answer: Plasmodium falciparum

      Explanation:

      Plasmodium falciparum is a parasite that is vector-borne which is transmitted by the female Anopheles mosquito.Bordetella pertussis is transmitted through the respiratory tract, via respiratory droplets or direct contact with infectious secretions.Mycobacterium tuberculosis is transmitted via inhalation of infected respiratory droplets.HIV may be transmitted via sexual contact, vertical transmission from mothers to infants, and among injection drug users sharing infected needles, as well as through transfusion of infected blood products.Treponema pallidum transmission normally occurs during direct sexual contact with an individual who has an active primary or secondary syphilitic lesion.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      8.6
      Seconds
  • Question 31 - Detection of urinary Bence-Jones protein would be most suggestive of which of the...

    Correct

    • Detection of urinary Bence-Jones protein would be most suggestive of which of the following malignancies:

      Your Answer: Multiple myeloma

      Explanation:

      Bence Jones proteins are monoclonal immunoglobulin light chains found in urine (and plasma) of some patients with myeloma. Because of their relatively small size, light chains are readily excreted into the urine. The presence of significant amounts of Bence Jones proteins in urine is indicative of malignant B cell proliferation.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      3.6
      Seconds
  • Question 32 - A 40-year-old male presents to your clinic complaining of a cough with bloody...

    Incorrect

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

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

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

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      20.1
      Seconds
  • Question 33 - In the foetus at 4 months gestation, where does haematopoiesis mainly occur? ...

    Correct

    • In the foetus at 4 months gestation, where does haematopoiesis mainly occur?

      Your Answer: Liver and spleen

      Explanation:

      The first place that haematopoiesis occurs in the foetus is in the yolk sac. Later on, it occurs in the liver and spleen, which are the major hematopoietic organs from about 6 weeks until 6 – 7 months gestation. At this point, the bone marrow becomes the most important site. Haemopoiesis is restricted to the bone marrow in normal childhood and adult life.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      7.7
      Seconds
  • Question 34 - Regarding CSF (cerebrospinal fluid) production, approximately how much is produced per day? ...

    Correct

    • Regarding CSF (cerebrospinal fluid) production, approximately how much is produced per day?

      Your Answer: 500 ml

      Explanation:

      CSF fills the ventricular system, a series of interconnected spaces within the brain, and the subarachnoid space directly surrounding the brain. The intraventricular CSF reflects the composition of the brain’s extracellular space via free exchange across the ependyma, and the brain “floats” in the subarachnoid CSF to minimize the effect of external mechanical forces. The volume of CSF within the cerebral ventricles is approximately 30 mL, and that in the subarachnoid space is about 125 mL. Because about 0.35 mL of CSF is produced each minute, CSF is turned over more than three times daily. Approximately 500 mL of CSF is produced per day, at a rate of about 25 mL per hour.CSF is a filtrate of capillary blood formed largely by the choroid plexuses, which comprise pia mater, invaginating capillaries, and ependymal cells specialized for transport. The choroid plexuses are located in the lateral, third, and fourth ventricles. The lateral ventricles are situated within the two cerebral hemispheres. They each connect with the third ventricle through one of the interventricular foramina (of Monro). The third ventricle lies in the midline between the diencephalon on the two sides. The cerebral aqueduct (of Sylvius) traverses the midbrain and connects the third ventricle with the fourth ventricle. The fourth ventricle is a space defined by the pons and medulla below and the cerebellum above. The central canal of the spinal cord continues caudally from the fourth ventricle, although in adult humans the canal is not fully patent and continues to close with age.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      4.5
      Seconds
  • Question 35 - Which of the following is NOT a typical side effect of digoxin: ...

    Incorrect

    • Which of the following is NOT a typical side effect of digoxin:

      Your Answer: Yellow vision

      Correct Answer: Hypokalaemia

      Explanation:

      Digoxin does not cause hypokalaemia, but hypokalaemia does potentiate digoxin toxicity. The adverse effects of digoxin are frequently due to its narrow therapeutic window and include: Cardiac adverse effects – Sinoatrial and atrioventricular block, Premature ventricular contractions, PR prolongation and ST-segment depressionNausea, vomiting and diarrhoeaBlurred or yellow visionCNS effects – weakness, dizziness, confusion, apathy, malaise, headache, depression, psychosisThrombocytopenia and agranulocytosis (rare)Gynaecomastia in men in prolonged administration

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      2.7
      Seconds
  • Question 36 - A patient presents with a laceration on his hand and wrist that has...

    Correct

    • A patient presents with a laceration on his hand and wrist that has cut the nerve that innervates opponens pollicis.The opponens pollicis muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: The recurrent branch of the median nerve

      Explanation:

      Opponens pollicis is a small, triangular muscle that forms part of the thenar eminence. It originates from the flexor retinaculum and the tubercle of trapezium bone and inserts into the whole length of the first metacarpal bone on its radial side.Opponens pollicis is innervated by the recurrent branch of the median nerve and receives its blood supply from the superficial palmar arch.The main action of opponens pollicis is to flex the first metacarpal bone at the carpometacarpal joint, which opposes the thumb towards the centre of the palm. It also medially rotates the first metacarpal bone at the carpometacarpal joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.4
      Seconds
  • Question 37 - 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
      3.4
      Seconds
  • Question 38 - Which of the following ligaments supports the head of the talus? ...

    Correct

    • Which of the following ligaments supports the head of the talus?

      Your Answer: Spring ligament

      Explanation:

      The spring-ligament complex is a significant medial arch stabilizer. The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      3.8
      Seconds
  • Question 39 - Regarding the accessory nerve, which of the following statements is INCORRECT: ...

    Correct

    • Regarding the accessory nerve, which of the following statements is INCORRECT:

      Your Answer: Accessory nerve palsy results in the inability to nod the head.

      Explanation:

      Accessory nerve palsy results in inability to shrug the shoulders and to rotate the head to look at the opposite side to the lesion.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      4
      Seconds
  • Question 40 - A patient presents with increased breathlessness and worsening of his chronic cough and....

    Correct

    • A patient presents with increased breathlessness and worsening of his chronic cough and. He has a chronic lung disorder and is on long-term oxygen therapy (LTOT).Which of these is an indication for LTOT?

      Your Answer: A non-smoker with COPD and a PaO 2 of 7.5 kPa when stable with secondary polycythaemia

      Explanation:

      Long-term administration of oxygen, usually at least 15 hours daily, improves survival in COPD patients who have severe hypoxaemia. Long-term oxygen therapy should be considered in:A non-smoker with COPD and a PaO2<7.3 kPa when stableA non-smoker with COPD and PaO27.3–8 kPa when stable and with secondary polycythaemia, peripheral oedema, or evidence of pulmonary hypertensionSevere chronic asthma with PaO2<7.3 kPa or persistent disabling breathlessnessA patient with Interstitial lung disease with PaO28 kPa with disabling dyspnoeaA patient with cystic fibrosis when PaO2<7.3 kPa or if PaO27.3–8 kPa in the presence of secondary polycythaemia, nocturnal hypoxaemia, pulmonary hypertension, or peripheral oedemaPulmonary hypertension, without parenchymal lung involvement when PaO2<8 kPaNeuromuscular or skeletal disorders, after specialist assessmentObstructive sleep apnoea despite continuous positive airways pressure therapy, after specialist assessmentPulmonary malignancy or other terminal disease with disabling dyspnoeaHeart failure with daytime PaO2<7.3 kPa when breathing air or with nocturnal hypoxaemia

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      29.4
      Seconds
  • Question 41 - 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
      12.4
      Seconds
  • Question 42 - A 20-year-old female presents with painful wrist following a fall while skating. X-rays...

    Correct

    • A 20-year-old female presents with painful wrist following a fall while skating. X-rays shows fracture of the ulna.The initial phase of bone healing is?

      Your Answer: Haematoma at the fracture site

      Explanation:

      Haemorrhage occurs into the fracture site from the ruptured vessels in the bone marrow and those supplying the periosteum immediately after fracture. This hematoma formation is the first phase of bone healing.The 4 stages of bone healing are:Haematoma at the fracture site (provides a framework for healing)Callus formationLamellar bone formationRemodelling

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5.9
      Seconds
  • Question 43 - A 42-year-old woman presents with face swelling prominently affecting her upper lip and...

    Incorrect

    • A 42-year-old woman presents with face swelling prominently affecting her upper lip and hands. She has previously been diagnosed with hereditary angioedema.Which of these is the most appropriate management option for this acute attack?

      Your Answer: C1 esterase infusion

      Correct Answer: Fresh frozen plasma

      Explanation:

      Hereditary angioedema is inherited as an autosomal dominant disorder and is caused by deficiency of C1 esterase inhibitor, a protein that forms part of the complement system.Attacks can be precipitated by stress and minor surgical procedures. Clinical features of hereditary angioedema include oedema of the skin and mucous membranes commonly affecting the face, tongue and extremities.Angioedema and anaphylaxis due to a deficiency of C1 esterase inhibitor are resistant to adrenaline, steroids and antihistamines. Treatment is with fresh frozen plasma or C1 esterase inhibitor concentrate, which contains C1 esterase inhibitor.Short-term prophylaxis for events that may precipitate angioedema attack is achieved with C1 esterase inhibitor or fresh frozen plasma infusions before the event while long-term prophylaxis can be achieved with antifibrinolytic drugs (tranexamic acid) or androgenic steroids.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      6.2
      Seconds
  • Question 44 - An elderly patient presents to ED following a fall after feeling light headed...

    Correct

    • An elderly patient presents to ED following a fall after feeling light headed when standing up. You are reviewing his medication and note that he is taking a high dose of furosemide. Loop diuretics act primarily at which of the following sites in the nephron:

      Your Answer: Thick ascending limb

      Explanation:

      Loop diuretics inhibit the Na+/K+/2Cl- symporter on the luminal membrane in the thick ascending limb of the loop of Henle, thus preventing reabsorption of NaCl and water. These agents reduce reabsorption of Cl- and Na+ and increase Ca2+ excretion and loss of K+ and Mg2+.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      9.8
      Seconds
  • Question 45 - The pathophysiology of Addison's disease is as follows: ...

    Correct

    • The pathophysiology of Addison's disease is as follows:

      Your Answer: Adrenocortical insufficiency

      Explanation:

      Primary adrenal insufficiency, also known as Addison’s disease, occurs when the adrenal glands cannot produce an adequate amount of hormones despite a normal or increased corticotropin (ACTH) level.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      6.1
      Seconds
  • Question 46 - A patient with a high potassium level is at risk of going into...

    Correct

    • A patient with a high potassium level is at risk of going into cardiac arrest. What changes in the ECG may indicate the incident of cardiac arrest in this patient?

      Your Answer: Peaked T waves and broad QRS complex

      Explanation:

      Severe hyperkalaemia can result in a heart attack or a life-threatening arrhythmia. T waves become narrow-based, pointed, and tall if hyperkalaemia is not treated. The QRS complex widens and eventually merges with the T wave, resulting in a classic sine-wave electrocardiogram. Ventricular fibrillation and asystole are likely to follow.

    • This question is part of the following fields:

      • Physiology
      • Renal
      5.3
      Seconds
  • Question 47 - You're examining a 58-year-old male who has cellulitis in his left leg. Because...

    Correct

    • You're examining a 58-year-old male who has cellulitis in his left leg. Because he is allergic to penicillin, you start him on erythromycin.Which of the following statements about erythromycin is correct?

      Your Answer: It can be used to treat Legionnaire’s disease

      Explanation:

      Bacteriostatic antibiotics include erythromycin and other macrolide antibiotics. They work by attaching to the bacterial ribosome’s 50S subunit, preventing translocation and thereby protein synthesis. Macrolide antibiotics are actively concentrated inside leukocytes and delivered to the infection site as a result.Erythromycin is an orally active antibiotic that can also be given intravenously. It is metabolized in the liver and eliminated in the bile and has a biological half-life of 1.5 hours.It has a similar antibacterial spectrum to benzylpenicillin (i.e., a narrow spectrum, primarily against Gram-positive pathogens) and can be used as a penicillin substitute in people who are allergic to penicillin.Erythromycin is unsuccessful in the treatment of meningitis because it does not penetrate the central nervous system well enough. It is efficient against a variety of unusual pathogens, unlike penicillin.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      7.8
      Seconds
  • Question 48 - A patient sustains an injury to the proximal median nerve after falling through...

    Correct

    • A patient sustains an injury to the proximal median nerve after falling through a glass door. Which of the following muscles would you not expect to be affected:

      Your Answer: Flexor carpi ulnaris

      Explanation:

      All of the muscles in the anterior forearm are innervated by the median nerve, except for the flexor carpi ulnaris and the medial half of the flexor digitorum profundus which are innervated by the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      18.2
      Seconds
  • Question 49 - A patient complains of stomach ache. You see a midline scar in the...

    Incorrect

    • A patient complains of stomach ache. You see a midline scar in the epigastric area when you examine the abdomen. Upon further interrogation, the patient reveals that she had a subtotal gastrectomy for recurring stomach ulcers several years ago. The stomach mucosa secretes a variety of vital compounds, and her ability to secrete some of these molecules has been harmed as a result of his surgery.The stomach D-cells secrete which of the following substances?

      Your Answer: Histamine

      Correct Answer: Somatostatin

      Explanation:

      Somatostatin-producing cells present in the pyloric antrum, duodenum, and pancreatic islets are known as D-cells or delta-cells. Somatostatin inhibits gastric acid secretion by acting directly on acid-producing parietal cells in the stomach via a G-protein coupled receptor. By suppressing the release of other hormones such as gastrin, secretin, and histamine, somatostatin can indirectly reduce stomach acid output, slowing the digesting process.The table below summarizes the many cell types found in the stomach, as well as the substances secreted by each cell type and the function of the secretion:Cell type/ Substance secreted/ Function of secretionParietal cells/ Hydrochloric acid/ Kills microbes and activates pepsinogenParietal cells/ Intrinsic factor/Binds to vitamin B12 and facilitates its absorptionChief cells/ Pepsinogen/ Protein digestionChief cells/ Gastric lipase/ Fat digestionG-cells/ Gastrin/ Stimulates gastric acid secretionEnterochromaffin-like cells (ECL cells) /Histamine/ Stimulates gastric acid secretionMucous-neck cells/ Mucous and bicarbonate/ Protects stomach epithelium from acidD-cells/ Somatostatin/ Inhibits gastric acid secretion

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      15.9
      Seconds
  • Question 50 - Which of the following is NOT an effect of benzodiazepines: ...

    Correct

    • Which of the following is NOT an effect of benzodiazepines:

      Your Answer: Analgesic effect

      Explanation:

      Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists which enhance inhibitory synaptic transmission throughout the central nervous system, with sedative, hypnotic, anxiolytic, anticonvulsant, amnesic and muscle relaxant properties.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      8.6
      Seconds
  • Question 51 - Which of the following statements regarding forest plots is true? Select ONE answer...

    Correct

    • Which of the following statements regarding forest plots is true? Select ONE answer only.Which of the following statements regarding forest plots is true? Select ONE answer only.

      Your Answer: Larger studies are associated with smaller horizontal lines

      Explanation:

      Forest plots are graphical displays designed to illustrate the relative strength of treatment effects in multiple individual studies addressing the same question.

    • This question is part of the following fields:

      • Evidence Based Medicine
      7
      Seconds
  • Question 52 - Regarding bias, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Increasing the sample size reduces bias.

      Correct Answer: Bias leads to the systematic difference between the results from a study and the true states of affair.

      Explanation:

      Bias is the term used to describe an error at any stage of the study that was not due to chance. Bias leads to the systematic difference between the results from a study and the true states of affair. Bias may be introduced at all stages of the research process, from study design, through to analysis and publication. Bias can create a spurious association or mask a real association.Good research design can reduce the effect of bias (e.g. blinding, randomisation) but they cannot eliminate it completely. Increasing the sample size does not reduce bias.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      9.3
      Seconds
  • Question 53 - In relation to ketamine, which of the following statements is TRUE: ...

    Correct

    • In relation to ketamine, which of the following statements is TRUE:

      Your Answer: It is usually associated with tachycardia, increased blood pressure and increased cardiac output.

      Explanation:

      Ketamine has hypnotic, analgesic and local anaesthetic properties. Major adverse effects include Hypertension, Increased cardiac output, Increased ICP, Tachycardia, Tonic-clonic movements, Visual hallucinations and Vivid dreams.Ketamine is mostly utilized in paediatric anaesthesia, especially when repeated dosing is necessary (such as for serial burns dressings). Ketamine has little effect on respiratory drive, and protective airway reflexes are unaffected. Ketamine is also a bronchial smooth muscle relaxant, hence it plays a unique function in the treatment of severe asthma.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      25.9
      Seconds
  • Question 54 - Identify the type of graph described below:A graph that is a useful summary...

    Correct

    • Identify the type of graph described below:A graph that is a useful summary of a set of bivariate data (two variables), usually drawn before working out a linear correlation coefficient or fitting a regression line.

      Your Answer: Scatterplot

      Explanation:

      A scatterplot is a useful summary of a set of bivariate data (two variables), usually drawn before working out a linear correlation coefficient or fitting a regression line. It gives a good visual picture of the relationship between the two variables, and aids the interpretation of the correlation coefficient or regression model. Each unit contributes one point to the scatterplot, on which points are plotted but not joined. The resulting pattern indicates the type and strength of the relationship between the two variables.

    • This question is part of the following fields:

      • Evidence Based Medicine
      10.2
      Seconds
  • Question 55 - The first line drug for oral candidiasis is: ...

    Correct

    • The first line drug for oral candidiasis is:

      Your Answer: Nystatin

      Explanation:

      Treatment for oral candidiasis is with nystatin mouthwash. In unresponsive cases, oral fluconazole is used

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      3.1
      Seconds
  • Question 56 - A foot drop is a sign of damage to which of the following...

    Correct

    • A foot drop is a sign of damage to which of the following nerves?

      Your Answer: Deep fibular nerve

      Explanation:

      The deep fibular nerve was previously referred to as the anterior tibial nerve. It starts at the common fibular nerve bifurcation, between the fibula and the proximal part of the fibularis longus. Damage to this nerve can cause foot drop or loss of dorsiflexion since this nerve controls the anterior leg muscles.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      14.9
      Seconds
  • Question 57 - A 19-year-old with a longstanding history of asthma presents to the ED with...

    Correct

    • A 19-year-old with a longstanding history of asthma presents to the ED with worsening symptoms of cough and wheeze and a peak expiratory flow rate (PEFR) measurement is taken.Which statement concerning PEFR is true?

      Your Answer: PEFR is dependent upon the patient's height

      Explanation:

      The maximum flow rate generated during a forceful exhalation, after maximal inspiration is the peak expiratory flow rate (PEFR).PEFR is dependent upon initial lung volume. It is, therefore, dependant on patient’s age, sex and height.PEFR is dependent on voluntary effort and muscular strength of the patient.PEFR is decreased with increasing airway resistance, e.g. in asthma, and it correlates well with the forced expiratory volume in one second (FEV1) value measured in spirometry. This correlation decreases in patients with asthma as airflow decreases.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      9.6
      Seconds
  • Question 58 - You are teaching a group of medical students about cardiovascular examination. You are...

    Correct

    • You are teaching a group of medical students about cardiovascular examination. You are discussing heart sounds and the cardiac cycle. Which of the following stages of the cardiac cycle occurs immediately after the aortic valve closes:

      Your Answer: Isovolumetric relaxation

      Explanation:

      Immediately after the closure of the semilunar valves, the ventricles rapidly relax and ventricular pressure decreases rapidly but the AV valves remain closed as initially the ventricular pressure is still greater than atrial pressure. This is isovolumetric relaxation. Atrial pressure continues to rise because of venous return, with the v wave of the JVP waveform peaking during this phase. Rapid flow of blood from the atria into the ventricles during the ventricular filling phase causes thethird heart sound, which is normal in children but, in adults, is associated with disease such as ventricular dilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      21.1
      Seconds
  • Question 59 - You are prescribing ipratropium bromide for a patient who has presented with an...

    Correct

    • You are prescribing ipratropium bromide for a patient who has presented with an exacerbation of her COPD. What is the mechanism of action of ipratropium bromide:

      Your Answer: Muscarinic antagonist

      Explanation:

      Ipratropium bromide is an antimuscarinic drug used in the management of acute asthma and COPD. It can provide short-term relief in chronic asthma, but short-acting β2agonists act more quickly and are preferred.The BTS guidelines recommend that nebulised ipratropium bromide (0.5 mg 4-6 hourly) can be added to β2agonist treatment for patients with acute severe or life-threatening asthma or those with a poor initial response to β2 agonist therapy.The aerosol inhalation of ipratropium can be used for short-term relief in mild chronic obstructive pulmonary disease in patients who are not already using a long-acting antimuscarinic drug (e.g. tiotropium).Its maximum effect occurs 30-60 minutes after use; its duration of action is 3-6 hours, and bronchodilation can usually be maintained with treatment three times per day.The commonest side effect of ipratropium bromide is dry mouth. It can also trigger acute closed-angle glaucoma in susceptible patients. Tremor is commonly seen with β2agonists but not with antimuscarinics. Ipratropium bromide should be used with caution in: Men with prostatic hyperplasia and bladder-outflow obstruction (worsened urinary retention has been reported in elderly men), People with chronic kidney disease (CKD) stages 3 and above (because of the risk of drug toxicity), People with angle-closure glaucoma (nebulised mist of antimuscarinic drugs can precipitate or worsen acute angle-closure glaucoma)

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      4.1
      Seconds
  • Question 60 - Gentamicin is contraindicated in which of the following: ...

    Correct

    • Gentamicin is contraindicated in which of the following:

      Your Answer: Myasthenia gravis

      Explanation:

      Gentamicin is the aminoglycoside of choice in the UK and is used widely for the treatment of serious infections. It has a broad spectrum but is inactive against anaerobes and has poor activity against haemolytic streptococci and pneumococci. When used for the blind therapy of undiagnosed serious infections it is usually given in conjunction with a penicillin or metronidazole (or both). The main toxic effects are nephrotoxicity and ototoxicity due to damage to the vestibulocochlear nerve (CN VIII).Gentamicin is contraindicated in myasthenia gravis and should be used with caution in renal disease which may result in accumulation and a greater risk of toxic side effects.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      4.5
      Seconds
  • Question 61 - Which of the following statements is true about anterior cord syndrome? ...

    Correct

    • Which of the following statements is true about anterior cord syndrome?

      Your Answer: There is preservation of proprioception

      Explanation:

      Anterior cord syndrome is an incomplete cord syndrome that predominantly affects the anterior 2/3 of the spinal cord, characteristically resulting in motor paralysis below the level of the lesion as well as the loss of pain and temperature at and below the level of the lesion. The patient presentation typically includes these two findings; however, there is variability depending on the portion of the spinal cord affected. Other findings include back pain, or autonomic dysfunction such as hypotension, neurogenic bowel or bladder, and sexual dysfunction. The severity of motor dysfunction can vary, typically resulting in paraplegia or quadriplegia.Proprioception, vibratory sense, two-point discrimination, and fine touch are not affected in anterior cord syndrome. These sensations are under the control of the dorsal column of the spinal cord, which is supplied by two posterior spinal arteries running in the posterior lateral sulci.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      8.5
      Seconds
  • Question 62 - The correct statement about the glomerular filtration barrier is which of the following?...

    Correct

    • The correct statement about the glomerular filtration barrier is which of the following?

      Your Answer: The basement membrane is negatively charged, restricting filtration of negatively charged molecules.

      Explanation:

      The main factor in determining whether a substance is filtered or not is molecular weight. Molecules < 7 kDa in molecular weight e.g. glucose, amino acids, urea, ions are filtered freely, but larger molecules are increasingly restricted up to 70 kDa, and there is very little filtration for anything above this. There is further restriction of negatively charged molecules because they are repelled by negative charges, particularly in the basement membrane. Albumin, which has a molecular weight of 69 kDa and is negatively charged, is filtered but only in very small amounts. All of the filtered albumin is reabsorbed in the proximal tubule. Small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. Other than the ultrafiltrate being essentially protein free, it has an otherwise identical composition of plasma. Bowman's capsule consists of:- an epithelial lining which consists of a single layer of cells called podocytes- endothelium which is perforated by pores or fenestrations – this allows plasma components with a molecular weight of < 70 kDa to pass freely.

    • This question is part of the following fields:

      • Physiology
      • Renal
      14.5
      Seconds
  • Question 63 - You review a 56-year-old man who has recently been prescribed antibiotics for a...

    Correct

    • You review a 56-year-old man who has recently been prescribed antibiotics for a chest infection. He suffers from COPD and is currently prescribed salbutamol and Seretide inhalers, and Phyllocontin continus. Since starting the antibiotics, he has been experiencing nausea, vomiting and abdominal pain.Which of the following antibiotics is he MOST LIKELY to have been prescribed for his chest infection? Select ONE answer only .

      Your Answer: Levofloxacin

      Explanation:

      Phyllocontin continus contains aminophylline (a mixture of theophylline and ethylenediamine), a bronchodilator used in the management of COPD and asthma.This patient is exhibiting symptoms of theophylline toxicity, which may have been triggered by the prescription of the antibiotic. Quinolone antibiotics, such as ciprofloxacin and levofloxacin, and macrolide antibiotics, such as erythromycin, increase the plasma concentration of theophyllines and can lead to toxicity.The drugs that commonly affect the half-life and the plasma concentration of theophylline are summarised in the table below:Drugs increasing plasma concentration of theophyllineDrugs decreasing plasma concentration of theophyllineCalcium channel blockers, e.g. VerapamilCimetidineFluconazoleMacrolides, e.g. erythromycinQuinolones, e.g. ciprofloxacinMethotrexateBarbituratesCarbamazepinePhenobarbitolPhenytoin (and fosphenytoin)RifampicinSt. John’s wort

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      18.4
      Seconds
  • Question 64 - Regarding control of hospital acquired infection (HAI), which of the following statements is...

    Correct

    • Regarding control of hospital acquired infection (HAI), which of the following statements is CORRECT:

      Your Answer: Chlorhexidine is an anti-staphylococcal agent.

      Explanation:

      Chlorhexidine is an anti-staphylococcal agent. Cleaning is the removal of foreign material from areas or objects to a point at which they are visually free from debris.  Disinfection is the reduction in the number of infectious particles. Isopropyl alcohol is not effective against C. difficile spores. Autoclaving is a method of sterilisation.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      18.8
      Seconds
  • Question 65 - 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: 0.06

      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
      54.4
      Seconds
  • Question 66 - A 40-year-old woman presents with a fever and headache upon returning from an...

    Correct

    • A 40-year-old woman presents with a fever and headache upon returning from an overseas business trip. Upon further investigation, a diagnosis of Plasmodium falciparum malaria was made.All of the following statements is considered true regarding Plasmodium falciparum malaria, except:

      Your Answer: It is commonly the result of travel in the Indian subcontinent

      Explanation:

      The mean incubation period for P. falciparum is 12 days.WHO World Malaria Report 2019 states that an estimated 228 million cases of malaria occurred worldwide in 2018, and reports steadily decreasing the number of cases since 2010. In 2018, nineteen sub-Saharan African countries and India carried approximately 85% of the global malaria burden. The most prevalent and pathogenic malaria parasite, most commonly associated with severe illness and death, especially in the WHO African region, accounting for 99.7% malaria cases, is P. falciparum.The vector for Plasmodium spp. is a female Anopheles mosquito that inoculates sporozoites contained in her salivary glands into the puncture wound when feeding. Sporozoites enter peripheral bloodstream and are uptake by hepatocytes, where they undergo an asexual pre-erythrocytic liver-stage as liver schizonts lasting up to 2 weeks before the onset of the blood stage.Intravenous or intramuscular artesunate is the first-line treatment in all patients worldwide and should be used for at least 24 hours and until the oral medication is tolerated.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      21.6
      Seconds
  • Question 67 - You want to give colchicine to a patient who has acute gout. Which...

    Correct

    • You want to give colchicine to a patient who has acute gout. Which of the following is a contraindication to the use of colchicine?

      Your Answer: Blood dyscrasias

      Explanation:

      Colchicine is used to prevent or treat gout attacks (flares). It works by reducing swelling and the development of uric acid crystals, which cause pain in the affected joint(s). Colchicine should be avoided by patients who have blood dyscrasias or bone marrow disorders.

    • This question is part of the following fields:

      • Musculoskeletal
      • Pharmacology
      9.5
      Seconds
  • Question 68 - About case-control studies, one of the following is true. ...

    Correct

    • About case-control studies, one of the following is true.

      Your Answer: They are suitable to be used in the study of rare diseases

      Explanation:

      Case-control studies are suitable when investigating a rare disease or in cases where little is known about the disease and the proposed aetiological factor, as a preliminary study. They have the ability to look at multiple risk-factors (exposures) but can only look at a single outcome.In a case-control study, two groups of patients, one with the disease and one without, are compared on the basis of a proposed causative factor that occurred in the past. They are therefore a retrospective study and useful in hypothesis generation.Cohort studies are better at identifying rare exposures. One group with an exposure is compared to a control group without that exposure.Case-control studies are usually less expensive to run and also shorter in duration compared with prospective cohort studies.

    • This question is part of the following fields:

      • Evidence Based Medicine
      16
      Seconds
  • Question 69 - Regarding shingles, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: You can catch chickenpox from a patient with shingles.

      Explanation:

      After primary infection, VZV remains latent in sensory ganglia and in about 20% of patients will reactivate resulting in shingles, a painful vesicular rash in the related dermatome. Shingles usually affects older people and the immunocompromised. Shingles lesions are infectious to non-immune individuals who are at risk of developing chickenpox. Shingles can not be contracted directly from chickenpox, or from other cases of shingles. Shingles is treated with systemic antiviral treatment to reduce the severity and duration of pain, reduce complications, and reduce viral shedding.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      3.8
      Seconds
  • Question 70 - Haemophilia B results from a deficiency in: ...

    Incorrect

    • Haemophilia B results from a deficiency in:

      Your Answer: Factor VIII

      Correct Answer: Factor IX

      Explanation:

      Haemophilia B is a bleeding disorder caused by a deficiency of clotting factor IX. It is the second commonest form of haemophilia, and is rarer than haemophilia A. Haemophilia B tends to be similar to haemophilia A but less severe. The two disorders can only be distinguished by specific coagulation factor assays.The incidence is one-fifth of that of haemophilia A. Laboratory findings demonstrate prolonged APTT, normal PT and low factor IX.Haemophilia B inherited in an X-linked recessive fashion, affecting males born to carrier mothers.There is also a variation called Leyden, in which factor IX levels are below 1% until puberty, when they rise, potentially reaching as high as 40-60% of normal. This is thought to be due to the effects of testosterone at puberty.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      7.1
      Seconds
  • Question 71 - A thyroid function test is done for a 55-year-old woman with non-specific symptoms,...

    Correct

    • A thyroid function test is done for a 55-year-old woman with non-specific symptoms, the results are shown below:TSH = 5.2Free T4 is normalFree T3 is normalThe most likely diagnosis in this patient is?

      Your Answer: Subclinical hypothyroidism

      Explanation:

      Hypothyroidism is diagnosed using the results of thyroid function tests (TFTs). In the early stages of the disease, the earliest biochemical change noticed is a rise in thyroid-stimulating hormone (TSH) levels. Free triiodothyronine (T3) and thyroxine (T4) levels are usually normal.In primary hypothyroidism, the serum TSH level is usually greater than 10 mU/L, and free T4 levels are below the reference range.Subclinical hypothyroidism is diagnosed when the serum TSH level is above the reference range, and the free T4 levels are within the reference range. The test should, however, be repeated after 3-6 months to exclude transient causes of raised TSH.In summary, how to interpret TFTs in cases of suspected hypothyroidism is shown below:Subclinical hypothyroidismTSH is raisedFree T4 is normalFree T3 is normalPrimary hypothyroidismTSH is raisedFree T4 is loweredFree T3 is lowered or normalSecondary hypothyroidismTSH is lowered or normalFree T4 is loweredFree T3 is lowered or normal

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      11.5
      Seconds
  • Question 72 - Which of the following factors decreases insulin secretion: ...

    Correct

    • Which of the following factors decreases insulin secretion:

      Your Answer: Catecholamines

      Explanation:

      Factors that increase insulin secretion:↑ Blood glucose↑ Amino acids↑ Fatty acidsGlucagonSecretinAcetylcholineFactors that decrease insulin secretion:↓ Blood glucoseSomatostatinCatecholamines

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      7.9
      Seconds
  • Question 73 - Which of the following globin chains makes up normal adult haemoglobin (HbA)? ...

    Correct

    • Which of the following globin chains makes up normal adult haemoglobin (HbA)?

      Your Answer: Two alpha and two beta chains

      Explanation:

      Total adult haemoglobin comprises about 96 – 98 % of normal adult haemoglobin (HbA). It consists of two alpha (α) and two beta (β) globin chains.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      4.4
      Seconds
  • Question 74 - Adenosine is primarily indicated for which of the following: ...

    Correct

    • Adenosine is primarily indicated for which of the following:

      Your Answer: Paroxysmal supraventricular tachycardia

      Explanation:

      Adenosine is usually the treatment of choice for terminating paroxysmal supraventricular tachycardia including those associated with accessory conduction pathways e.g. Wolff-Parkinson-White syndrome.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      3.6
      Seconds
  • Question 75 - Regarding gastric motility and emptying, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding gastric motility and emptying, which of the following statements is CORRECT:

      Your Answer: Mixing of food with gastric secretions occurs predominantly in the fundus and body of the stomach.

      Correct Answer: Gastric emptying is inhibited by the presence of the products of fat digestion in the duodenum.

      Explanation:

      Gastric emptying is decreased by the presence of fats in the duodenum (by stimulating release of cholecystokinin). Mixing of the food with gastric secretions takes place in the distal body and antrum of the stomach where the muscularis externa layer is thicker. The stomach has an additional inner oblique smooth muscle layer (in addition to the inner circular layer and outer longitudinal layer). Gastric emptying is increased by a low gastric pH and decreased by a low duodenal pH.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      23.9
      Seconds
  • Question 76 - A 36-year-old man who works in a farm presents with a deep laceration...

    Correct

    • A 36-year-old man who works in a farm presents with a deep laceration over the palm of his hand. A median nerve block was performed at his wrist to facilitate wound exploration and closure.Which of the following statements regarding median nerve blocks at the wrist is considered correct?

      Your Answer: The needle should be inserted approximately 2.5 cm proximal to flexor retinaculum

      Explanation:

      A median nerve block is a simple, safe, and effective method of obtaining anaesthesia to the palmar aspect of the thumb, index finger, middle finger, radial portion of the palm and ring finger. The median nerve lies deep to the flexor retinaculum and about one centimetre under the skin of the volar wrist.The palmaris longus tendon lies superficial to the retinaculum and is absent in up to 20% of patients.The median nerve is located slightly lateral (radial) to the palmaris longus tendon and medial (ulnar) to the flexor carpi radialis tendon.The procedure is as follows:- Check sensation and motor function of the median nerve. Wear gloves and use appropriate barrier precautions.- Locate the flexor carpi radialis and palmaris longus tendons, which become prominent when the patient flexes the wrist against resistance. The palmaris longus tendon is usually the more prominent of the two tendons.- Needle-entry site: The needle will be inserted adjacent to the radial (lateral) border of the palmaris longus tendon just proximal to the proximal wrist crease. If the palmaris longus tendon is absent, the needle-entry site is about 1 cm ulnar to the flexor carpi radialis tendon.- Cleanse the site with antiseptic solution. Place a skin wheal of anaesthetic, if one is being used, at the needle-entry site.- Insert the needle perpendicularly through the skin and advance it slowly until a slight pop is felt as the needle penetrates the flexor retinaculum. When paraesthesia in the distribution of the median nerve confirms proper needle placement, withdraw the needle 1 to 2 mm.- Aspirate to exclude intravascular placement and then slowly (i.e., over 30 to 60 seconds) inject about 3 mL of anaesthetic. If the patient does not feel paraesthesia, redirect the needle in an ulnar direction, under the palmaris longus tendon. If paraesthesia is still not felt, slowly inject 3 to 5 mL of anaesthetic in the proximity of the nerve 1 cm deep to the tendon.- Allow about 5 to 10 minutes for the anaesthetic to take effect.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.9
      Seconds
  • Question 77 - An 18-year-old student presents with a 1-week history of sore throat, low grade...

    Incorrect

    • 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: High-grade fever

      Correct 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
      19.2
      Seconds
  • Question 78 - A 26-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.Which...

    Correct

    • A 26-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.Which of the following is NOT an action of the gluteus maximus muscle? Select ONE answer only.

      Your Answer: Hip abduction

      Explanation:

      Gluteus maximus is the main extensor muscle of the hip and assists with lateral rotation of the thigh at the hip joint. It also acts as a hip adductor, steadies the thigh, and assists in raising the trunk from a flexed position.Gluteus maximus is innervated by the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.7
      Seconds
  • Question 79 - The correct statement regarding the parasympathetic nervous system is which of the following?...

    Incorrect

    • The correct statement regarding the parasympathetic nervous system is which of the following?

      Your Answer: Parasympathetic postganglionic neurones release noradrenaline which acts on adrenergic receptors.

      Correct Answer: Parasympathetic preganglionic neurones run in cranial nerves III, VII, IX and X.

      Explanation:

      The electron transfer system is responsible for most of the energy produced during respiration. The is a system of hydrogen carriers located in the inner mitochondrial membrane. Hydrogen is transferred to the electron transfer system via the NADH2 molecules produced during glycolysis and the Krebs cycle. As a result, a H+ion gradient is generated across the inner membrane which drives ATP synthase. The final hydrogen acceptor is oxygen and the H+ions and O2 combine to form water.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      23.5
      Seconds
  • Question 80 - A 26-year-old woman is currently 9 weeks pregnant. Upon interview and history taking,...

    Incorrect

    • A 26-year-old woman is currently 9 weeks pregnant. Upon interview and history taking, she mentioned that she visited a friend whose child had just been diagnosed with slapped cheek disease.If the mother contracts an illness during pregnancy, which among the following is not known to cause fetal abnormalities?

      Your Answer: Rubella

      Correct Answer: Hepatitis A

      Explanation:

      Hepatitis A usually doesn’t pose a special risk to a pregnant woman or her baby. Maternal infection doesn’t result in birth defects, and a mother typically doesn’t transmit the infection to her baby. HAV is almost always transmitted by the faecal-oral route and is usually acquired through close personal contact or via contaminated food.When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes scars, defects of muscle and bone, malformed and paralyzed limbs, small head size, blindness, seizures, and intellectual disability.TORCH Syndrome refers to infection of a developing foetus or newborn by any of a group of infectious agents. “TORCH” is an acronym meaning (T)toxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex.Infection with any of these agents may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and other symptoms and findings.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      24.6
      Seconds
  • Question 81 - You've been asked to give a discussion to a group of medical students...

    Correct

    • You've been asked to give a discussion to a group of medical students about skeletal muscle physiology and its use in clinical medicine. They pose a series of difficult questions to you.Which of the following definitions for the A-band of the sarcomere is correct?

      Your Answer: A band that contains the entire length of a single thick filament (myosin)

      Explanation:

      Myofibrils, which are around 1 m in diameter, make up each myofiber. The cytoplasm separates them and arranges them in a parallel pattern along the cell’s long axis. These myofibrils are made up of actin and myosin filaments that are repeated in sarcomeres, which are the myofiber’s basic functional units.Myofilaments are the filaments that make up myofibrils, and they’re made mostly of proteins. Myofilaments are divided into three categories:Myosin filaments are thick filaments made up mostly of the protein myosin.Actin filaments are thin filaments made up mostly of the protein actin.Elastic filaments are mostly made up of the protein titin.The sarcomere is a Z-line segment that connects two adjacent Z-lines.The I-bands are thin filament zones that run from either side of the Z-lines to the thick filament’s beginning.Between the I-bands is the A-band, which spans the length of a single thick filament.The H-zone is a zone of thick filaments that is not overlaid by thin filaments in the sarcomere’s centre. The H-zone keeps the myosin filaments in place by surrounding them with six actin filaments each.The M-band (or M-line) is a disc of cross-connecting cytoskeleton elements in the centre of the H-zone.The thick filament is primarily made up of myosin. The thin filament is primarily made up of actin. Actin, tropomyosin, and troponin are found in a 7:1:1 ratio in thin filaments.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      25.3
      Seconds
  • Question 82 - Regarding the routine childhood immunisation schedule, which of the following vaccines is given...

    Correct

    • Regarding the routine childhood immunisation schedule, which of the following vaccines is given to preschool children (aged 3 years and 4 months):

      Your Answer: Measles, mumps and rubella (MMR)

      Explanation:

      The current UK childhood immunisation schedule is as follows:8 weeks:DTaP/IPV(polio)/Hib/Hep B (diptheria, tetanus, pertussis, polio,Haemophilus influenzatype b and hepatitis B) – 6-in-one injection (Infranix hexa);plus:Rotavirus gastroenteritis (Rotarix) – oral route (drops)Meningitis B (Bexsero)12 weeks:DTaP/IPV(polio)/Hib/Hep B – 2nddose: 6-in-one injection, 2nddose (Infranix hexa);plus:PCV (pneumococcal conjugate vaccine) – in a separate injection (Prevenar 13)Rotavirus gastroenteritis 2nddose (Rotarix) – oral route (drops)16 weeks:DTaP/IPV(polio)/Hib/Hep B – 3rddose: 6-in-one injection, 3rddose (Infranix hexa);plus:Meningitis B 2nddose (Bexsero)Between 12 and 13 months:Hib/Men C (combined as one injection) – 4th dose of Hib and 1stdose of Meningitis C (Menitorix);plus:MMR (measles, mumps and rubella) – combined as one injection (Priorix or M-M-RVAXPRO);plus:PCV (pneumococcal conjugate vaccine) – 2nddose in a separate injection (Prevenar 13);plus:Meningitis B 3rddose (Bexsero)From 2 to end of primary school:Nasal flu spray (Fluenz Tetra). For children aged 2,3 and 4, this is usually given in the GP surgery. Children in school years 1,2 and 3 may have this at school.3 years and 4 months:Pre-school booster of DTaP/IPV (polio) – 4-in-one injection (Repevax or Infanrix-IPV);plus:MMR – 2nd dose (Priorix or M-M-RVAXPRO) – in a separate injectionBetween 12 and 13 years:HPV (human papilloma virus types 6,11, 16 and 18) –twoinjections of Gardasil given. The second injection is given 6-24 months after the first one.14 years:Td/IPV (polio) booster – 3-in-one injection (Revaxis)Men ACWY: combined protection against meningitis A, C, W and Y (Nimenrix or Menveo)The BCG vaccination against tuberculosis is only offered to neonates in high-risk areas or with high-risk backgrounds. When required it is usually given before leaving the hospital soon after birth.

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      9.6
      Seconds
  • Question 83 - On his stool culture, a patient with a diarrhoeal illness grows Escherichia coli.What...

    Correct

    • On his stool culture, a patient with a diarrhoeal illness grows Escherichia coli.What SINGLE statement about Escherichia coli is true?

      Your Answer: Most serotypes are harmless

      Explanation:

      Escherichia coli is a Gram-negative, non-spore forming, facultative anaerobic, rod-shaped bacterium. Although some can cause serious food poisoning, most serotypes are harmless.Escherichia coli is transmitted via the faeco-oral route.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      5.6
      Seconds
  • Question 84 - The patient is a 78-year-old woman who has recently developed left-sided hemiplegia. A...

    Correct

    • The patient is a 78-year-old woman who has recently developed left-sided hemiplegia. A CT head scan is performed, and the diagnosis of an ischaemic stroke is confirmed. Her blood pressure is currently very high, with the most recent measurement being 196/124 mmHg, according to the nurse in charge. While you wait for the stroke team to review her, she asks you to prescribe something to help lower the patient's blood pressure.Which of the following is the best drug treatment for this patient's BP reduction?

      Your Answer: Labetalol

      Explanation:

      End-organ damage (e.g. encephalopathy, intracranial haemorrhage, acute myocardial infarction or ischaemia, dissection, pulmonary oedema, nephropathy, eclampsia, papilledema, and/or angiopathic haemolytic anaemia) characterises a hypertensive emergency (also known as ‘accelerated hypertension’ or malignant hypertension’ It’s a life-threatening condition that necessitates rapid blood pressure reduction to avoid end-organ damage and a negative outcome.In the setting of a stroke syndrome (i.e., in the presence of focal neurological deficits), hypertensive emergencies usually necessitate a slower and more controlled blood pressure reduction than in other situations. Rapid reduction of MAP in the presence of an ischaemic stroke can compromise blood flow, leading to further ischaemia and worsening of the neurological deficit. In this situation, intravenous labetalol is the drug of choice for lowering blood pressure.Significantly elevated blood pressure (>185/110 mmHg) is a contraindication to thrombolysis, but there is some evidence for controlling blood pressure before thrombolysis in exceptional circumstances, when it is only slightly above this threshold.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      16.3
      Seconds
  • Question 85 - A 54-year-old woman presents with polyuria and polydipsia. She is known to suffer...

    Incorrect

    • A 54-year-old woman presents with polyuria and polydipsia. She is known to suffer from bipolar disorder, which has been well controlled by the use of lithium for many years.What is the SINGLE most likely diagnosis?

      Your Answer: Psychogenic polydipsia

      Correct Answer: Nephrogenic diabetes insipidus

      Explanation:

      Diabetes insipidus is the inability to produce concentrated urine. It is characterised by the presence of excessive thirst, polyuria and polydipsia. There are two distinct types of diabetes insipidus:Cranial (central) diabetes insipidus and;Nephrogenic diabetes insipidusCranial diabetes insipidus is caused by a deficiency of vasopressin (anti-diuretic hormone). Patients with cranial diabetes insipidus can have a urine output as high as 10-15 litres per 24 hours, but adequate fluid intake allows most patients to maintain normonatraemia. 30% of cases are idiopathic, and a further 30% are secondary to head injuries. Other causes include neurosurgery, brain tumours, meningitis, granulomatous disease (e.g. sarcoidosis) and drugs, such as naloxone and phenytoin. A very rare inherited form also exists that is associated with diabetes mellitus, optic atrophy, nerve deafness and bladder atonia.Nephrogenic diabetes insipidus is caused by renal resistance to the action of vasopressin. As with cranial diabetes insipidus, urine output is markedly elevated. Serum sodium levels can be maintained by secondary polydipsia or can be elevated. Causes of nephrogenic diabetes insipidus include chronic renal disease, metabolic disorders (e.g. hypercalcaemia and hypokalaemia) and drugs, including long-term lithium usage and demeclocycline.In view of the history of long-term lithium use, in this case, nephrogenic diabetes insipidus is the most likely diagnosis.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      14.5
      Seconds
  • Question 86 - For the treatment of his atrial fibrillation, a 67-year-old man is about to...

    Incorrect

    • For the treatment of his atrial fibrillation, a 67-year-old man is about to begin taking warfarin. He also takes a number of other medications.Which of the following medications will prevent warfarin from working?

      Your Answer: Sodium valproate

      Correct Answer: Phenytoin

      Explanation:

      Many medications, including warfarin, require cytochrome P450 enzymes for their metabolism. When co-prescribing cytochrome p450 enzyme inducers and inhibitors with warfarin, it’s critical to be cautious.Inhibitors of the cytochrome p450 enzyme inhibit the effects of warfarin, resulting in a lower INR. To remember the most commonly encountered cytochrome p450 enzyme inducers, use the mnemonic PC BRASS:P– PhenytoinC– CarbamazepineB– BarbituratesR– RifampicinA– Alcohol (chronic ingestion)S– SulphonylureasS– Smoking

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      13
      Seconds
  • Question 87 - A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a...

    Incorrect

    • A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a poor response and you administer another nebuliser with ipratropium bromide added on.Which statement about ipratropium bromide is true?

      Your Answer: It is a first-line treatment for moderate asthma attacks

      Correct Answer: It can trigger acute closed-angle glaucoma

      Explanation:

      Ipratropium bromide is an antimuscarinic drug. It is used in the management of acute asthma and COPD. It provides short-term relief in chronic asthma. Short-acting β2agonists are preferred and act more quickly.The commonest side effect of ipratropium bromide is dry mouth. Tremor is commonly seen with β2agonists. It can trigger acute closed-angle glaucoma in patients that are susceptible. First-line treatment for moderate asthma attacks is short-acting β2agonists.The BTS guidelines recommend that nebulised ipratropium bromide (0.5 mg 4-6 hourly) be added to β2agonist treatment in patients with a poor initial response to β2agonist therapy or with acute severe or life-threatening asthma.Its duration of action is 3-6 hours, maximum effect occurs 30-60 minutes after use, and bronchodilation can be maintained with three times per day dosing.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      22.5
      Seconds
  • Question 88 - A 32-year-old female is diagnosed case of bipolar disorder and is on medication....

    Correct

    • A 32-year-old female is diagnosed case of bipolar disorder and is on medication. She presents to her psychiatric team with symptoms of severe depression. She is currently taking Lithium. Out of the following, which is TRUE regarding lithium?

      Your Answer: It commonly causes a tremor

      Explanation:

      Lithium is the drug of choice for bipolar disorders but is commonly associated with side effects and toxicity. Fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy with Lithium. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer. Lithium tremors are more common with older age, presumably due to the additive effects of age-related essential tremors.Option The normal therapeutic range is 2.0-2.5 mmol/l: Lithium should be carefully monitored as it has a very low therapeutic index. The normal therapeutic range is 0.4-0.8 mmol/l. Levels should be checked one week after starting therapy and one week after every change in dosage. (Option Levels should be checked one month after starting therapy) Option It can induce hyperthyroidism: Lithium has a known effect on thyroid function. Lithium decreases the production of T4 and T3 and commonly causes hypothyroidism. More rarely, lithium causes hyperthyroidism due to thyroiditis.Option It can induce diabetes mellitus: Lithium can induce nephrogenic diabetes insipidus but not diabetes mellitus.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      12.8
      Seconds
  • Question 89 - 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
      9.1
      Seconds
  • Question 90 - A 35 year old man presents with a deep laceration to the proximal...

    Correct

    • A 35 year old man presents with a deep laceration to the proximal part of the forearm. On further assessment, the patient is unable to flex the metacarpophalangeal joints and interphalangeal joints of the index, middle finger and the thumb. The ring and little fingers are intact but there is weakness at the proximal interphalangeal joint.There is also loss of sensation over the lateral palm and the palmar surface of the lateral three and a half fingers. Which of these nerve(s) has most likely been affected?

      Your Answer: Median nerve

      Explanation:

      A median nerve injury affecting the extrinsic and intrinsic muscles of the hand will present with:Loss of sensation to the lateral palm and the lateral three and a half fingers.Weakness of flexion at the metacarpophalangeal joints of the index and middle finger. This is because of paralysis of the lateral two lumbricals. Weakness of flexion of the proximal interphalangeal joints of all four fingers due to paralysis of the flexor digitorum superficialisWeakness of flexion at the distal interphalangeal joints of the index and middle finger following paralysis of the lateral half of the flexor digitorum profundus.Weakness of thumb flexion, abduction and opposition due to paralysis of the flexor pollicis longus and thenar muscles

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      36.3
      Seconds
  • Question 91 - Which of the following statements is considered correct regarding Hepatitis B vaccination? ...

    Incorrect

    • Which of the following statements is considered correct regarding Hepatitis B vaccination?

      Your Answer: Antibody titres should be tested 1 to 2 weeks after the primary course

      Correct Answer: The vaccine should be stored between 2 and 8 degrees Centigrade

      Explanation:

      Hepatitis B vaccine should be stored at 35°-46° F (2°-8° C) and should not be frozen.There is no association between hepatitis B vaccination and Guillain-Barre syndrome. Infection with the bacterium Campylobacter jejuni is one of the most common risk factors for GBS. People can also develop GBS after having the flu or other infections (such as cytomegalovirus and Epstein Barr virus).Hepatitis B vaccine is prepared from initial concentration of surface antigen.To ensure adequate immunity, anti-HBs (HBsAb) titres may be checked 4-8 weeks following the last shot of the hepatitis B vaccine series.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      14.3
      Seconds
  • Question 92 - CSF is reabsorbed from subarachnoid space via which of the following structures: ...

    Correct

    • CSF is reabsorbed from subarachnoid space via which of the following structures:

      Your Answer: Arachnoid granulations

      Explanation:

      From the subarachnoid cisterns in the subarachnoid space, CSF is reabsorbed via arachnoid granulations which protrude into the dura mater, into the dural venous sinuses and from here back into the circulation.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      3
      Seconds
  • Question 93 - A 45-year-old obese patient goes to the emergency department with a fever and...

    Correct

    • A 45-year-old obese patient goes to the emergency department with a fever and significant right upper quadrant pain. The pain radiates to her right shoulder tip.  Murphy's sign is positive and acute cholecystitis is diagnosed. The pain referred to the shoulder tip is caused by one of the following nerves:

      Your Answer: Phrenic nerve

      Explanation:

      Gallbladder inflammation can cause pain in the right upper quadrant and right shoulder, which is caused by irritation of the diaphragmatic peritoneum. Pain from areas supplied by the phrenic nerve is often referred to other somatic regions served by spinal nerves C3-C5.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      8
      Seconds
  • Question 94 - In adults, there are normally how many teeth: ...

    Correct

    • In adults, there are normally how many teeth:

      Your Answer: 32

      Explanation:

      In adults, there are 32 teeth, 16 in the upper jaw and 16 in the lower jaw. On each side in both upper and lower arches, there are two incisors, one canine, two premolars and three molar teeth.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      3.4
      Seconds
  • Question 95 - Osteoclasts are a type of bone cell that are critical in the maintenance,...

    Correct

    • Osteoclasts are a type of bone cell that are critical in the maintenance, repair and remodelling of bones.Which of the following inhibits osteoclast activity? Select ONE answer only.

      Your Answer: Calcitonin

      Explanation:

      Osteoclasts are a type of bone cell that breaks down bone tissue. This is a critical function in the maintenance, repair and remodelling of bones. The osteoclast disassembles and digests the composite of hydrated protein and minerals at a molecular level by secreting acid and collagenase. This process is known as bone resorption and also helps to regulate the plasma calcium concentration.Osteoclastic activity is controlled by a number of hormones:1,25-dihydroxycholecalciferol increases osteoclastic activityParathyroid hormone increases osteoclastic activityCalcitonin inhibits osteoclastic activityBisphosphonates are a class of drug that slow down and prevent bone damage. They are osteoclast inhibitors.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      5.7
      Seconds
  • Question 96 - A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited...

    Incorrect

    • A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited range of motion in the right elbow for the past two days. On examination, the right elbow is extremely tender with erythema and warmth of the overlying skin due to acute inflammation. Which ONE of the following statements is true with regards to acute inflammation?

      Your Answer: Increased intravascular osmotic pressure leads to oedema

      Correct Answer: Neutrophils are activated and adhere to the endothelium as a result of interaction with endothelial cell adhesion molecules

      Explanation:

      Acute inflammation is defined as inflammation occurring within minutes to hours in response to an injury lasting for less than two weeks. Acute inflammation Rapid onset (minutes to hours)Quick resolution (usually days)Chronic inflammationMay last weeks, months, or yearsThere are five cardinal signs of inflammation:1) Pain2) Redness3) Warmth4) Oedema5) Loss of functionDuring acute inflammation, neutrophils are activated and attracted to the site of inflammation in response to various interleukins and cytokines. This process takes place via the following mechanism:1) MarginationNeutrophils flow nearer the vessel wall rather than in the axial stream, which is referred to as margination2) Rolling along the surface of vascular endothelium3) Adhesion to the endothelium by interaction with adhesion molecules (ICAMS and VCAMS)4) Diapedesis is the movement of neutrophils from the endothelial cells into the interstitial space by squeezing through the gaps between adjacent endothelial cellsBradykinin and histamine are both responsible for vasodilation which causes oedema and decreases intravascular osmotic pressure.Neutrophils dominate early (2 days)- Live longer- Replicate in tissues

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      73.8
      Seconds
  • Question 97 - Which law describes the rate of diffusion in a solution? ...

    Correct

    • Which law describes the rate of diffusion in a solution?

      Your Answer: Fick’s law

      Explanation:

      Fick’s law describes the rate of diffusion in a solution. Fick’s law states that:Jx = -D A (ΔC / Δx)Where:Jx = The amount of substance transferred per unit timeD = Diffusion coefficient of that particular substanceA = Surface area over which diffusion occursΔC = Concentration difference across the membraneΔx = Distance over which diffusion occursThe negative sign reflects movement down the concentration gradient

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      2.3
      Seconds
  • Question 98 - If the afferent arteriole's diameter is smaller than the efferent arteriole's diameter in...

    Correct

    • If the afferent arteriole's diameter is smaller than the efferent arteriole's diameter in the glomerulus:

      Your Answer: The net filtration pressure will decrease

      Explanation:

      The relative resistance of the afferent and efferent arterioles substantially influences glomerular capillary hydrostatic pressure and consequently GFR. Filtration is forced through the filtration barrier due to high pressure in the glomerular capillaries. Afferent arteriolar constriction lowers this pressure while efferent arteriolar constriction raises it.

    • This question is part of the following fields:

      • Physiology
      • Renal
      10.4
      Seconds
  • Question 99 - Compliance is decreased by all but which one of the following: ...

    Correct

    • Compliance is decreased by all but which one of the following:

      Your Answer: Aging

      Explanation:

      Factors increasing compliance:Old ageEmphysemaFactors decreasing compliance:Pulmonary fibrosisPulmonary oedemaAtelectasisExtremes of lung volumes (at higher lung volumes the compliance of the lung becomes less as the lung becomes stiffer)

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      3.4
      Seconds
  • Question 100 - Regarding loop diuretics, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding loop diuretics, which of the following statements is INCORRECT:

      Your Answer: Oral bumetanide acts within 1 hour and diuresis is complete within 6 hours.

      Correct Answer: The risk of hypokalaemia is greater with loop diuretics than with an equipotent dose of a thiazide diuretic.

      Explanation:

      Hypokalaemia can occur with both thiazide and loop diuretics. The risk of hypokalaemia depends on the duration of action as well as the potency and is thus greater with thiazides than with an equipotent dose of a loop diuretic. Hypokalaemia is dangerous in severe cardiovascular disease and in patients also being treated with cardiac glycosides. Often the use of potassium-sparing diuretics avoids the need to take potassium supplements. In hepatic failure, hypokalaemia caused by diuretics can precipitate encephalopathy, particularly in alcoholic cirrhosis.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      16.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Infections (4/4) 100%
Microbiology (8/14) 57%
Haematology (2/4) 50%
Pathology (5/8) 63%
Cardiovascular Pharmacology (1/4) 25%
Pharmacology (18/29) 62%
Specific Pathogen Groups (2/6) 33%
Abdomen And Pelvis (0/2) 0%
Anatomy (18/22) 82%
Principles (2/2) 100%
Abdomen (3/3) 100%
Gastrointestinal (1/2) 50%
Physiology (15/20) 75%
Pathogens (2/3) 67%
Head And Neck (2/2) 100%
Lower Limb (4/4) 100%
CNS Pharmacology (2/3) 67%
General Pathology (2/3) 67%
Inflammatory Responses (1/1) 100%
Upper Limb (4/5) 80%
Central Nervous System (4/5) 80%
Respiratory (4/5) 80%
Thorax (0/1) 0%
Evidence Based Medicine (4/7) 57%
Statistics (1/1) 100%
Cardiovascular (4/6) 67%
Anaesthesia (2/3) 67%
Principles Of Microbiology (1/2) 50%
Basic Cellular (2/3) 67%
Cranial Nerve Lesions (1/1) 100%
Respiratory Pharmacology (2/4) 50%
Endocrine Physiology (2/3) 67%
Endocrine (2/2) 100%
Renal (3/3) 100%
Gastrointestinal Physiology (0/1) 0%
Study Methodology (0/1) 0%
Respiratory Physiology (1/1) 100%
Musculoskeletal (1/1) 100%
Basic Cellular Physiology (2/2) 100%
Immunoglobulins And Vaccines (1/1) 100%
Renal Physiology (0/1) 0%
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