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  • Question 1 - A 25-year-old man suffers from a shoulder injury that damaged the nerve that...

    Incorrect

    • A 25-year-old man suffers from a shoulder injury that damaged the nerve that innervates the infraspinatus muscle.Which of the following nerves may most likely be affected?

      Your Answer: The axillary nerve

      Correct Answer: The suprascapular nerve

      Explanation:

      The suprascapular nerve (C5-C6) innervates the infraspinatus. It originates at the superior trunk of the brachial plexus. It runs laterally across the lateral cervical region to supply the infraspinatus and also the supraspinatus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      60.1
      Seconds
  • Question 2 - A 30-year-old male farmer presents to the Emergency Department due to a wound...

    Correct

    • A 30-year-old male farmer presents to the Emergency Department due to a wound on his right forearm sustained two days ago while working on the farm. He cleaned the wound under a tap, but there was still some dirt and debris on examination. Past medical history reveals that he never received a tetanus vaccine. After cleaning the wound and prescribing antibiotics, which ONE of the following actions should be taken to manage his tetanus risk?

      Your Answer: Tetanus vaccination and 500 IU tetanus immunoglobulin

      Explanation:

      If a patient presents with one of the following types of wounds, they are at risk of contracting tetanus and should be vaccinated immediately:1) Contaminated puncture-type wounds from gardening and farming (as they may contain tetanus spores)2) Wounds containing foreign bodies3) Open (compound) fractures4) Wounds or burns with sepsis5) Animal bites and scratches (animal saliva does not contain tetanus spores unless the animal was routing in soil or lives in an agriculture setting)Extremely high-risk tetanus-prone wounds are any of the above wounds with one of the following:1) Any wound contaminated by materials containing tetanus spores, e.g., soil, manure2) Burns or wounds with extensive devitalised tissue3) Wounds or burns with surgical intervention delayed for more than six hours even if the initial injury was not heavily contaminatedThe CDC recommends that adults who have never been vaccinated for tetanus receive a quick shot of the tetanus vaccine along with a booster dose ten years later. A tetanus-prone wound in an unvaccinated individual should also receive a high dose of tetanus immunoglobulin. The injected antibodies will prevent tetanus infection as the patient does not have any pre-existing antibodies against the disease.In this case, the patient has a high risk, contaminated wound. He should receive a high dose of tetanus immunoglobulin along with the tetanus vaccine. (The preventative dose of tetanus immunoglobulin is 250 IU in most cases unless over 24 hours have passed since the injury or the wound is heavily contaminated, then 500 IU should be given.) His physician also needs to be contacted to arrange the remainder of the course as indicated in this case.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      19.3
      Seconds
  • Question 3 - A 62 year old man has sustained a penetrating injury to the submandibular...

    Incorrect

    • A 62 year old man has sustained a penetrating injury to the submandibular triangle. On examination, his tongue is weak and when protruded deviates to the left. Which of the following nerves has most likely been injured:

      Your Answer: Right glossopharyngeal nerve

      Correct Answer: Left hypoglossal nerve

      Explanation:

      Damage to the hypoglossal nerve results in weakness of the tongue, with deviation of the tongue towards the weak side on protrusion.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      69.8
      Seconds
  • Question 4 - Which of the following statements is correct regarding gentamicin? ...

    Incorrect

    • Which of the following statements is correct regarding gentamicin?

      Your Answer: Gentamicin is effective against haemolytic streptococci.

      Correct Answer: Gentamicin is ineffective against anaerobic bacteria.

      Explanation:

      Gentamicin is the aminoglycoside of choice in the UK and is a parenterally administered, broad spectrum antibiotic typically used for moderate to severe gram negative infections. However, it is inactive against anaerobes. There is poor activity against haemolytic streptococci and pneumococci. It is usually given in conjunction with a penicillin or metronidazole (or both) when used for the blind treatment of undiagnosed serious infections. Nephrotoxicity and ototoxicity are the main toxic effects due to damage to the vestibulocochlear nerve (CN VIII).It is contraindicated in myasthenia gravis and should be used with great care in renal disease as it may result in accumulation and a higher risk of toxic side effects.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      34.7
      Seconds
  • Question 5 - Due to a traffic accident, a male patient was unable to flex his...

    Incorrect

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

      Your Answer: Axillary and thoracodorsal nerve

      Correct Answer: Axillary and suprascapular nerve

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      59.5
      Seconds
  • Question 6 - Which of the following best describes the typical rash of measles: ...

    Correct

    • Which of the following best describes the typical rash of measles:

      Your Answer: The typical rash of measles is maculopapular, starting behind the ears and spreading downwards to the trunk.

      Explanation:

      A prodromal 2 – 4 day coryzal illness (fever, cough, conjunctivitis, irritability) normally occurs associated with Koplik’s spots (small white papules found on the buccal mucosa near the first premolars), before a morbilliform maculopapular rash appears, first behind the ears and then spreading downwards to whole body.The rash peels off or fades about about 7 – 10 days. The chickenpox rash is characterised by a maculopapular rash progressing to vesicles and then crusting over. Scarlet fever is characterised by a sandpaper like rash associated with a strawberry tongue.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      28.5
      Seconds
  • Question 7 - Regarding renal clearance, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding renal clearance, which of the following statements is CORRECT:

      Your Answer: Creatinine is freely filtered and neither reabsorbed or secreted.

      Correct Answer: The MDRD equation uses plasma creatinine to estimate the GFR making an adjustment for age, sex and race.

      Explanation:

      Clearance is defined as the volume of plasma that is cleared of a substance per unit time. Inulin clearance is the gold standard for measurement of GFR but creatinine clearance is typically used instead. Creatinine is freely filtered and not reabsorbed, but there is a little creatinine tubular secretion. In practice, GFR is usually estimated from the plasma creatinine using a formula e.g. the MDRD equation making an adjustment for age, sex and race.

    • This question is part of the following fields:

      • Physiology
      • Renal
      48.2
      Seconds
  • Question 8 - A new chemotherapy drug is being tested. The intervention reduces the risk of...

    Correct

    • A new chemotherapy drug is being tested. The intervention reduces the risk of death from 10 in 1000 to 5 in 1000. What is the number needed to treat to prevent one death:

      Your Answer: 200

      Explanation:

      Absolute risk reduction (ARR) of treatment = risk of death in control group – risk of death in treatment groupARR = (10/1000) – (5/1000) = 5/1000 = 0.005Number needed to treat (NNT) = 1/ARR = 1/0.005 = 200Therefore 200 people would need to be treated to prevent one extra death.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      31.2
      Seconds
  • Question 9 - All of the following statement are correct regarding endothelium derived nitric oxide except:...

    Incorrect

    • All of the following statement are correct regarding endothelium derived nitric oxide except:

      Your Answer: Nitric oxide inhibits platelet activation and thrombosis.

      Correct Answer: Nitric oxide production is inhibited by local mediators such as bradykinin, histamine and serotonin.

      Explanation:

      Factors that elevate intracellular Ca2+ increase nitric oxide (NO) production by the endothelium included local mediators such as histamine and serotonin, bradykinin, and some neurotransmitters like substance P. NO production is also stimulated by increased flow (shear stress) and additionally activates prostacyclin synthesis. As a result of basal production of NO, there is continuous modulation of vascular resistance and as a result, there is increased production of nitric oxide acts which causes vasodilation. Platelet activation and thrombosis are inhibited by nitric oxide.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      38.6
      Seconds
  • Question 10 - Intracellular [Ca2+] rise in cardiac excitation-contraction coupling is mainly as a result of:...

    Correct

    • Intracellular [Ca2+] rise in cardiac excitation-contraction coupling is mainly as a result of:

      Your Answer: Ca 2+ release from sarcoplasmic reticulum

      Explanation:

      Although Ca2+entry during the action potential (AP) is essential for contraction, it only accounts for about 25% of the rise in intracellular Ca2+. The rest is released from Ca2+stores in the sarcoplasmic reticulum (SR). APs travel down invaginations of the sarcolemma called T-tubules, which are close to, but do not touch, the terminal cisternae of the SR. During the AP plateau, Ca2+enters the cell and activates Ca2+sensitive Ca2+release channels in the sarcoplasmic reticulum allowing stored Ca2+to flood into the cytosol; this is called Ca2+-induced Ca2+release. The amount of Ca2+released is dependent on how much is stored, and on the size of the initial Ca2+influx during the AP.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      15.1
      Seconds
  • Question 11 - A 52-year-old man develops pneumonia 3 days following an admission for investigation of...

    Incorrect

    • A 52-year-old man develops pneumonia 3 days following an admission for investigation of chest pain. He has coarse left basal crackles and evidence of consolidation in the left lower lobe of chest X-ray. He has no known drug allergies.According to the latest NICE guidelines, which of the following antibacterial agents would be most appropriate to prescribe in this case? Select ONE answer only.

      Your Answer: Amoxicillin

      Correct Answer: Co-amoxiclav

      Explanation:

      Nosocomial infections are defined as those occurring within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation. They affect 1 in 10 patients admitted to hospital. Annually, this results in 5000 deaths with a cost to the National Health Service of a billion pounds. On average, a patient with hospital acquired infection spent 2.5-times longer in hospital, incurring additional costs of £3000 more than an uninfected patient. Intensive care units (ICU) have the highest prevalence of hospital-acquired infections in the hospital setting.The current recommendations by NICE and the BNF on the treatment of hospital acquired pneumonia are:Early onset infection(less than 5 days after admission to hospital): co-amoxiclav or cefuroxime for 7 daysLate-onset infection(more than 5 days after admission to hospital): an antipseudomonal penicillin (e.g. piperacillin with tazobactam), a broad-spectrum cephalosporin (e.g. ceftazidime), or a quinolone (e.g. ciprofloxacin)If the patient developed a hospital-acquired pneumonia within 5 days of admission – co-amoxiclav would be the most appropriate choice.If the patient has developed a hospital-acquired pneumonia > 5 days after admission – ciprofloxacin would be the most appropriate choice from the list of options available.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      43.4
      Seconds
  • Question 12 - Which of the following is NOT a function of antibodies: ...

    Incorrect

    • Which of the following is NOT a function of antibodies:

      Your Answer: Opsonise antigens for phagocytosis

      Correct Answer: Act as antigen receptors on T lymphocytes

      Explanation:

      Antibodies: Neutralise toxins and prevent attachment of pathogensTarget, opsonise or agglutinate (clump together) antigens for phagocytosisActivate the complement cascade (leading to lysis or opsonisation of the pathogen)Act as antigen receptors on B lymphocytesActivate antibody-dependent cell-mediated cytotoxicity by natural killer (NK) cells or T cytotoxic cellsProvide mucosal immunity (IgA-mediated)Stimulate degranulation of mast cells (IgE and IgG mediated)Provide passive immunity to the newborn (through transplacental passage of IgG and secretion of IgA in breast milk)

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      20.4
      Seconds
  • Question 13 - A 28-year-old woman in her second trimester is diagnosed with a psychiatric illness....

    Correct

    • A 28-year-old woman in her second trimester is diagnosed with a psychiatric illness. She is started on treatment with a drug. The treatment results in her baby being born with poor tone, feeding problems, hypothyroidism, and a goitreOut of the following, which drug is most likely responsible for the baby's condition?

      Your Answer: Lithium

      Explanation:

      In pregnancy and postpartum, lithium is an effective treatment for relapse prevention in bipolar disorder. However, lithium has also been associated with risks during pregnancy for both the mother and the unborn child. Recent large studies have confirmed the association between first-trimester lithium exposure and an increased risk of congenital malformations.Lithium levels need to be monitored more frequently throughout pregnancy and the postnatal period. If given in the 1st-trimester, lithium is associated with a risk of fetal cardiac malformations, such as Ebstein’s anomaly. If given in the 2nd and 3rd-trimesters, there is a risk of the following:1. hypotonia2. lethargy3. feeding problems4. hypothyroidism5. goitre6. nephrogenic diabetes insipidus in the neonate

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      22.2
      Seconds
  • Question 14 - C3 deficiency leads to particular susceptibility of infection with which of the following:...

    Incorrect

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

      Your Answer: Neisseria spp.

      Correct Answer: Encapsulated bacteria

      Explanation:

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

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      18.6
      Seconds
  • Question 15 - Elevation of the eyeball is primarily produced by which of the following muscles:...

    Correct

    • Elevation of the eyeball is primarily produced by which of the following muscles:

      Your Answer: Superior rectus and inferior oblique

      Explanation:

      Elevation of the eyeball is produced by the superior rectus and the inferior oblique muscles.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      29
      Seconds
  • Question 16 - Which of the following terms describes the proportion of individuals with a negative...

    Incorrect

    • Which of the following terms describes the proportion of individuals with a negative test result who actually do not have a disease:

      Your Answer: Positive predictive value

      Correct Answer: Negative predictive value

      Explanation:

      Negative predictive value (NPV) is the proportion of individuals with a negative test result who do not have the disease.NPV = d/(c+d)

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      25.7
      Seconds
  • Question 17 - A 53 year old women presents to the emergency room with a chronic...

    Correct

    • A 53 year old women presents to the emergency room with a chronic cough. The pulmonary receptors likely to be involved in causing her cough are:

      Your Answer: Irritant receptors

      Explanation:

      Throughout the airways, there are irritant receptors which are located between epithelial cells which are made of rapidly adapting afferent myelinated fibres in the vagus nerve. A cough is as a result of receptor stimulation located in the trachea, hyperpnoea is as a result of receptor stimulation in the lower airway. Stimulation may also result in reflex bronchial and laryngeal constriction. Many factors can stimulate irritant receptors. These include irritant gases, smoke and dust, airway deformation, pulmonary congestion, rapid inflation/deflation and inflammation. Deep augmented breaths or sighs seen every 5 – 20 minutes at rest are due to stimulation of these irritant receptors. This reverses the slow lung collapse that occurs in quiet breathing.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      15.9
      Seconds
  • Question 18 - A 68-year-old man is being treated with digoxin for atrial fibrillation. When serum...

    Correct

    • A 68-year-old man is being treated with digoxin for atrial fibrillation. When serum digoxin levels are above the therapeutic range, he is at highest risk for developing digoxin toxicity if he also develops which of the following?

      Your Answer: Hypokalaemia

      Explanation:

      Predisposing factors for digoxin toxicity include hypoxia, hypercalcaemia, hypokalaemia and hypomagnesaemia There should also be care taken in the elderly who are particularly susceptible to digoxin toxicity. Hypokalaemia may be precipitated by use of diuretics. Hyponatremia can result in the development of other pathological disturbances, but it does not make digoxin toxicity worse.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      15.7
      Seconds
  • Question 19 - Regarding ampicillin, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Ampicillin is first line treatment for acute sore throat.

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

      Explanation:

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

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      17.1
      Seconds
  • Question 20 - A 34-year-old man presented to the emergency room after being involved in a...

    Incorrect

    • A 34-year-old man presented to the emergency room after being involved in a road traffic accident. Upon observation and examination, it was noted that he was hypotensive and has muffled heart sounds. It was suspected that he has pericardial effusion, so an emergency pericardiocentesis was to be performed.In performing pericardiocentesis for suspected pericardial effusion, which of the following anatomical sites are at risk of being punctured?

      Your Answer: 5 th intercostal space in the mid-axillary line

      Correct Answer: 1 cm below the left xiphocostal angle

      Explanation:

      Pericardiocentesis is a procedure done to remove fluid build-up in the sac around the heart known as the pericardium. The pericardium can be tapped from almost any reasonable location on the chest wall. However, for the usual blind pericardiocentesis, the subxiphoid approach is preferred. Ideally, 2-D echocardiography is used to guide needle insertion and the subsequent path of the needle/catheter.In the subxiphoid approach, the needle is inserted 1 cm inferior to the left xiphocostal angle with an angle of 30 degrees from the patient’s chest with a direction towards the left mid-clavicle. The fingers may sense a distinct give when the needle penetrates the parietal pericardium. Successful removal of fluid confirms the needle’s position.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      31.7
      Seconds
  • Question 21 - A diagnosis of acute osteomyelitis was made on a patient with a known...

    Incorrect

    • A diagnosis of acute osteomyelitis was made on a patient with a known history of sickle cell disease. He has no joint prosthesis on in-dwelling metal work and no known drug allergies.Which of the following is most likely the causative agent of the case presented above?

      Your Answer: Staphylococcus aureus

      Correct Answer: Salmonella spp .

      Explanation:

      Patients with sickle cell disease are prone to infection of the bone and bone marrow in areas of infarction and necrosis. Although Staphylococcus aureus is the most common cause of osteomyelitis in the general population, studies have shown that in patients with sickle cell disease, the relative incidence of Salmonella osteomyelitis is twice that of staphylococcal infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      34
      Seconds
  • Question 22 - Following an injury sustained during a rugby match, a 16-year-old boy is brought...

    Incorrect

    • Following an injury sustained during a rugby match, a 16-year-old boy is brought to the Emergency Department by his mother. His forearm appears to be deformed, and you believe he has a distal radius fracture. A numerical rating scale is used to assess his pain, and the triage nurse informs you that he is in moderate pain.'The RCEM guidance recommends which of the following analgesics for the treatment of moderate pain in a child of this age?

      Your Answer: Oral paracetamol 10 mg/kg

      Correct Answer: Oral codeine phosphate 1 mg/kg

      Explanation:

      According to a 2018 audit conducted by the Royal College of Emergency Medicine (RCEM), the standard of care for children presenting to EDs with fractured limbs has deteriorated, with most patients waiting longer than ever before for pain relief. More than one-tenth of the children who came in with significant pain from a limb fracture received no pain relief at all.For all patients, including children, the Agency for Health Care Policy and Research (AHCPR) in the United States recommends using the ABCs of pain management:A – Ask about pain regularly. Assess pain systematically.B – Believe the patient and family in their reports of pain and what relieves it.C – Choose pain control options appropriate for the patient, family, and setting.D – Deliver interventions in a timely, logical, coordinated fashion.E – Empower patients and their families. Enable patients to control their course to the greatest extent possible.The RCEM guidelines recommend assessing a child’s pain within 15 minutes of arrival. This is a fundamental requirement. For the assessment of pain in children, a variety of rating scales are available; which one is used depends on the child’s age and ability to use the scale. These are some of them:Faces of Wong-Baker Scale for assessing painScale of numerical evaluationThe behavioural scale is a scale that measures how people behave.The RCEM has provided the following visual guide:The RCEM has established the following guidelines for when patients in severe pain should receive appropriate analgesia:100% within 60 minutes of arrival or triage, whichever is earliest75% within 30 minutes of arrival or triage, whichever is earliest50% within 20 minutes of arrival or triage, whichever is earliest

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      101.8
      Seconds
  • Question 23 - A patient has a diagnosis of acute osteomyelitis. They have no joint prosthesis...

    Incorrect

    • A patient has a diagnosis of acute osteomyelitis. They have no joint prosthesis on indwelling metal work and no known drug allergies. He has had a recent skin swab that has cultured MRSA and MRSA infection is suspected.Which of the following antibacterial agents would be most appropriate to prescribe in this case? Select ONE answer only.

      Your Answer: Flucloxacillin

      Correct Answer: Vancomycin

      Explanation:

      In the majority of patients the commonest causative organism for osteomyelitis isStaphylococcus aureus.Salmonella spp. are the commonest cause in patients with sickle cell disease.Other bacteria that can cause osteomyelitis include:Enterobacter spp.Group A and B streptococcusHaemophilus influenzaeThe current recommendations by NICE and the BNF on the treatment of osteomyelitis are:Flucloxacillin first-lineConsider adding fusidic acid or rifampicin for initial 2 weeksIf penicillin allergic use clindamycinIf MRSA is suspected use vancomycinSuggested duration of treatment is 6 weeks for acute infection

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      25.4
      Seconds
  • Question 24 - A patient suffers from an injury and as a consequence, the nerve that...

    Incorrect

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

      Your Answer: Superior gluteal nerve

      Correct Answer: Nerve to obturator internus

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      14.9
      Seconds
  • Question 25 - The transport of oxygen from maternal to fetal circulation is made possible by...

    Incorrect

    • The transport of oxygen from maternal to fetal circulation is made possible by fetal haemoglobin. Which of the statements about fetal haemoglobin (HbF) is also correct?

      Your Answer: It has a weaker affinity for oxygen than adult haemoglobin

      Correct Answer: The oxygen dissociation curve for foetal haemoglobin is shifted to the left of that of adult haemoglobin

      Explanation:

      Fetal haemoglobin is the most common type of haemoglobin found in the foetus during pregnancy. It transports oxygen from the maternal circulation to the fetal circulation. It can easily bind to oxygen from the maternal circulation because it has a high affinity for oxygen. From 10 to 12 weeks of pregnancy to the first six months after birth, the erythroid precursor cells produce fetal haemoglobin. In comparison to adult haemoglobin, fetal haemoglobin has two alpha and two gamma subunits, whereas adult haemoglobin has two alpha and two beta subunits in its major form. And, unlike adult haemoglobin, the oxygen dissociation curve of fetal haemoglobin is left-shifted. Myoglobin is an oxygen storage molecule with a very high affinity for oxygen. Only when the partial pressure of oxygen is exceeded does it release oxygen.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      32.9
      Seconds
  • Question 26 - In adult advanced life support, which of the following best describes the correct...

    Incorrect

    • In adult advanced life support, which of the following best describes the correct administration of adrenaline for a non-shockable rhythm:

      Your Answer: Give 0.5 mg of adrenaline as soon as intravenous access is achieved and every 3 - 5 minutes thereafter

      Correct Answer: Give 1 mg of adrenaline as soon as intravenous access is achieved and every 3 - 5 minutes thereafter

      Explanation:

      IV adrenaline 1 mg (10 mL of 1:10,000 solution) should be given after 3 shocks and every 3 – 5 minutes/after alternate shocks thereafter.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      46.1
      Seconds
  • Question 27 - A 71-year-old patient has been diagnosed with a dopamine-secreting neuroendocrine tumour.Which of the...

    Correct

    • A 71-year-old patient has been diagnosed with a dopamine-secreting neuroendocrine tumour.Which of the following statements about dopamine is correct?

      Your Answer: It inhibits prolactin release from the anterior pituitary

      Explanation:

      Dopamine is a neurotransmitter and amine hormone that is derived from the amino acid tyrosine. It is made in a number of places throughout the human body, both inside and outside the central nervous system. The adrenal medulla, dopamine neurons in the arcuate nucleus of the hypothalamus, the substantia nigra, and other areas of the brain produce dopamine.The tuberoinfundibular pathway refers to the dopamine neurons in the arcuate nucleus of the hypothalamus’ tubeal region. Dopamine is discharged into the hypothalamo-hypophyseal portal system from these neurons’ neurosecretory terminals at the median eminence.The major function of dopamine produced from the hypothalamus is to suppress prolactin production from the anterior pituitary, and it is released in reaction to excessive levels of prolactin secretion. Modulation of motor-control centres and activation of reward centres are two more crucial activities of the brain.Dopamine-secreting cells can also be found in other areas of the body, where they perform mostly paracrine functions (acting on nearby cells).

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      15.6
      Seconds
  • Question 28 - A 20-year-old male who is a known patient of sickle cell disease presents...

    Correct

    • A 20-year-old male who is a known patient of sickle cell disease presents to the Emergency Room with a sustained erection that is extremely painful. Out of the following clinical syndromes, which one does this patient most likely have?

      Your Answer: Priapism

      Explanation:

      Sickling of red blood cells can lead to several different clinical syndromes. If the sickling occurs in the corpora cavernosa, it can lead to a sustained, painful erection of the penis, referred to as priapism. One of the complications is long-term impotence. It is important to seek a urological opinion immediately in this case, but in the interim, treat with perineal ice packs and walk up and down the stairs.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      25.8
      Seconds
  • Question 29 - One of your patients has been infected by an obligate pathogen and presents...

    Incorrect

    • One of your patients has been infected by an obligate pathogen and presents with features of this condition.Which of these is an example of an obligate pathogen?

      Your Answer: Pseudomonas aeruginosa

      Correct Answer: Trepenoma pallidum

      Explanation:

      Treponema pallidum is an obligate pathogen. Obligate pathogens are almost always associated with disease and usually cannot survive outside of the body for long periods of time. Examples include and HIV.Staphylococcus aureus and Bacteroides fragilis are conditional pathogens. These are pathogens that usually cause disease only if certain conditions are met.Pneumocystis jiroveci and Pseudomonas aeruginosa, are opportunistic pathogens. These are pathogens that can only cause disease in an immunocompromised host or under unusual circumstances.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      39.4
      Seconds
  • Question 30 - Which of the following statements is correct with regards to insulin receptors? ...

    Correct

    • Which of the following statements is correct with regards to insulin receptors?

      Your Answer: Insulin has its intracellular effects via activation of tyrosine kinase.

      Explanation:

      Most cells have insulin receptors present on them which can be sequestered into the cell to inactivate them. These receptors consist of two extracellular alpha subunits which contain the insulin-binding site and two transmembrane beta subunits. Because insulin is a polypeptide hormone, it must act via cell surface receptors as it is unable to readily cross the cell membrane. On binding to the receptor, the beta subunit of insulin autophosphorylation, which activates tyrosine kinase. As a result, there is an intracellular cascade of phosphorylation, causing a translocation of the glucose transporter GLUT4 and GLUT-1 to the plasma membrane of the affected cell. This facilitates glucose entry.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      15.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (1/6) 17%
Upper Limb (0/2) 0%
Microbiology (2/6) 33%
Specific Pathogen Groups (1/3) 33%
Cranial Nerve Lesions (0/1) 0%
Infections (0/2) 0%
Pharmacology (2/6) 33%
Pathogens (1/1) 100%
Physiology (4/7) 57%
Renal (0/1) 0%
Evidence Based Medicine (1/2) 50%
Statistics (1/2) 50%
Cardiovascular (2/4) 50%
Principles Of Microbiology (0/2) 0%
Immune Responses (0/2) 0%
Pathology (1/3) 33%
CNS Pharmacology (1/2) 50%
Head And Neck (1/1) 100%
Respiratory (1/1) 100%
Abdomen And Pelvis (0/1) 0%
Lower Limb (0/1) 0%
Respiratory Physiology (0/1) 0%
Endocrine Physiology (1/1) 100%
Haematology (1/1) 100%
Endocrine (1/1) 100%
Passmed