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  • Question 1 - A 40-year-old female patient with a history of rheumatoid arthritis is diagnosed with...

    Correct

    • A 40-year-old female patient with a history of rheumatoid arthritis is diagnosed with type 1 renal tubular acidosis. What is the most probable sequela of this condition?

      Your Answer: Nephrocalcinosis

      Explanation:

      Distal renal tubular acidosis is due to defective proton secretion from the alpha intercalated cells of the distal tubule caused by dysfunction of the H+/K+ antiporter on the apical membrane. This leads to failure of H+ excretion thereby causing systemic acidosis and potassium depletion. Inability to lower the urine pH below 5.3 in the presence of systemic acidosis is the diagnostic hallmark of type I or distal renal tubular acidosis. Hypercalciuria, hypocitraturia and elevated urinary pH observed in distal renal tubular acidosis can lead to nephrocalcinosis and may cause renal calculi, obstructive uropathy and renal failure necessitating surgical or endoscopic stone extraction.

    • This question is part of the following fields:

      • Clinical Sciences
      16
      Seconds
  • Question 2 - A 23-year-old woman presents to the A&E with a 24-hour-history of gradual-onset fever,...

    Incorrect

    • A 23-year-old woman presents to the A&E with a 24-hour-history of gradual-onset fever, light sensitivity and headache. Clinical examination reveals neck stiffness and an area of rash which does not disappear upon pressure on her right shin. Anamnesis reveals a history of 3 episodes of meningococcal meningitis in the past and she was started on ceftriaxone for another suspected meningitis. However, you suspect that the patients might be immunodeficient. Which immunodeficiency does she most probably have?

      Your Answer: C5 deficiency

      Correct Answer: C5-9 deficiency

      Explanation:

      Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Fatality rates are substantial, and long-term sequelae develop in about half of survivors. Disease outcome has been related to the severity of the proinflammatory response in the subarachnoid space. The complement system, which mediates key inflammatory processes, has been implicated as a modulator of pneumococcal meningitis disease severity in animal studies. C5 fragment levels in cerebrospinal fluid (CSF) of patients with bacterial meningitis correlated with several clinical indicators of poor prognosis. The common terminal pathway consists of complement components C5–C9, and activation forms the anaphylatoxin C5a, a strong proinflammatory mediator, and the membrane attack complex (MAC), which creates pores in the bacterial cell wall (12). Deficiencies in these late complement components have been recognized as a cause of recurrent and familial meningococcal infections.

    • This question is part of the following fields:

      • Clinical Sciences
      9.4
      Seconds
  • Question 3 - The family of a 10-year-old boy was advised to take the boy to...

    Correct

    • The family of a 10-year-old boy was advised to take the boy to see an oncologist, for suspected lymphoma. The boy had lymphadenopathy on presentation. His mother says that he's had a fever, night sweats and has experienced weight loss. The boy underwent a lymph node biopsy at the oncologist which suggests Burkitt's lymphoma. Which oncogene are you expecting to see after molecular testing?

      Your Answer: c-MYC

      Explanation:

      Burkitt lymphoma is a germinal centre B-cell-derived cancer that was instrumental in the identification of MYC as an important human oncogene more than three decades ago. Recently, new genomics technologies have uncovered several additional oncogenic mechanisms that cooperate with MYC to create this highly aggressive cancer.

    • This question is part of the following fields:

      • Clinical Sciences
      54.9
      Seconds
  • Question 4 - Choose the part of the renal tubule which is impermeable to water: ...

    Incorrect

    • Choose the part of the renal tubule which is impermeable to water:

      Your Answer: Thick ascending limb of loop of Henle

      Correct Answer: Thin ascending limb of loop of Henle

      Explanation:

      The thick ascending limb actively reabsorbs NaCl but has an extremely low transepithelial osmotic water permeability, even in the presence of vasopressin. This combination of NaCl reabsorption without water reabsorption serves two vital functions: it provides NaCl to increase the osmolality of the medullary interstitium, tubules, vasculature, and collecting ducts; and it dilutes the luminal fluid within the thick ascending limb.

    • This question is part of the following fields:

      • Clinical Sciences
      4.1
      Seconds
  • Question 5 - A 21-year-old man presents with a three day history of general malaise and...

    Correct

    • A 21-year-old man presents with a three day history of general malaise and low-grade temperature. Yesterday he developed extensive painful ulceration of his mouth and gums. On examination his temperature is 37.4ºC, pulse 84 / min and there is submandibular lymphadenopathy. What is the most likely diagnosis?

      Your Answer: Herpes simplex virus infection

      Explanation:

      This man has gingivostomatitis, a characteristic feature of primary herpes simplex virus infection. Herpetic gingivostomatitis is often the initial presentation during the first (primary) herpes simplex infection. It is of greater severity than herpes labialis (cold sores) which is often the subsequent presentations. Primary herpetic gingivostomatitis is the most common viral infection of the mouth.
      Primary herpetic gingivostomatitis (PHGS) is caused predominantly by HSV-1 and affects mainly children. Prodromal symptoms, such as fever, anorexia, irritability, malaise and headache, may occur in advance of disease. Sub-mandibular lymphadenitis, halitosis and refusal to drink are usual concomitant findings.

    • This question is part of the following fields:

      • Clinical Sciences
      6.6
      Seconds
  • Question 6 - A 68-year-old male patient presents with haematemesis. Gastroscopy and biopsy reveal a carcinoma....

    Correct

    • A 68-year-old male patient presents with haematemesis. Gastroscopy and biopsy reveal a carcinoma. Who is the one to inform the patient of his diagnosis?

      Your Answer: The consultant in-charge of his care

      Explanation:

      One of the questions the therapist poses himself while informing a patient is: whom shall I inform about the diagnosis, treatment and prognosis? If we unconditionally accepted the view that information belongs to the patient from an ethical and legal standpoint, we would automatically exclude the partner and the family. Therefore, the therapist should raise another question: what is the benefit to the patient? To answer the question and the resulting dilemma, we have to leverage the long experience of family therapy and tailor it to the cases we are dealing with. It should be taken into consideration that patient and family are a dynamic system which was balanced before the onset of the disease, but is now disrupted, entering into crisis. Therefore, the denial mechanisms and personality characteristics we have previously elaborated on, and communication among members play a crucial role in determining the information strategy and the way family should be approached. In this particular case, the most appropriate person to inform the patient is the consultant, meaning the one currently responsible for the patient’s care. The patient most probably has already developed some form of close and trustful relationship with his consultant.

    • This question is part of the following fields:

      • Clinical Sciences
      3.3
      Seconds
  • Question 7 - A case-control study is developed to assess passive smoking as a risk factor...

    Correct

    • A case-control study is developed to assess passive smoking as a risk factor for the development of asthma in children. The total number of patients recruited for this study is 200. 40 out of the 200 patients report at least one parent smoking in the house when they were younger. 200 more people without asthma are recruited and 20 out of them report that at least one parent smoked in the house when they were younger. What is the odds ratio of patients with asthma having been exposed to passive smoking during their childhood?

      Your Answer: 2.25

      Explanation:

      An odds ratio (OR) is a measure of association between an exposure and an outcome. The OR represents the odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure. Odds ratios are most commonly used in case-control studies, however they can also be used in cross-sectional and cohort study designs as well (with some modifications and/or assumptions). Where

      a = Number of exposed cases

      b = Number of exposed non-cases

      c = Number of unexposed cases

      d = Number of unexposed non-cases

      OR=(a/c) / (b/d) = ad/bc

    • This question is part of the following fields:

      • Clinical Sciences
      193.9
      Seconds
  • Question 8 - Which one of the following statements regarding interleukin 1 (IL-1) is true? ...

    Correct

    • Which one of the following statements regarding interleukin 1 (IL-1) is true?

      Your Answer: It is released mainly by macrophages/monocytes

      Explanation:

      Interleukin 1 alpha and interleukin 1 beta (IL1 alpha and IL1 beta) are cytokines that participate in the regulation of immune responses, inflammatory reactions, and hematopoiesis. It is secreted mainly by macrophages and monocytes and acts as a costimulator of T cell and B cell proliferation.

    • This question is part of the following fields:

      • Clinical Sciences
      10.9
      Seconds
  • Question 9 - A study is developed to assess a new anti-hypertensive drug and two groups...

    Incorrect

    • A study is developed to assess a new anti-hypertensive drug and two groups of patients are randomly chosen. The first group takes an established anti-hypertensive drug for 3 months and the second group receives the new drug, again for 3 months. To assess the efficacy of the new drug, blood pressure is measured before and after taking the drug in both groups of patients. After a period of 1 month off medication, the groups swap medication and blood pressure is measured again, finally the difference in blood pressure after receiving each drug is calculated. Which of the following significance tests would you apply to assess the results of the study?

      Your Answer: Chi-squared test

      Correct Answer: Student's paired t-test

      Explanation:

      A t test is a type of statistical test that is used to compare the means of two groups. It is one of the most widely used statistical hypothesis tests in pain studies. There are two types of statistical inferences: parametric and nonparametric methods. Parametric methods refer to a statistical technique in which one defines the probability distribution of probability variables and makes inferences about the parameters of the distribution. In cases in which the probability distribution cannot be defined, nonparametric methods are employed. T tests are a type of parametric method; they can be used when the samples satisfy the conditions of normality, equal variance, and independence. In this case the data is parametric, and they belong to the same patients, so a paired t test should be used.

    • This question is part of the following fields:

      • Clinical Sciences
      94.7
      Seconds
  • Question 10 - A 23-year-old man is referred to the pneumologist with a suspicion of bronchiectasis....

    Correct

    • A 23-year-old man is referred to the pneumologist with a suspicion of bronchiectasis. History reveals he's been having recurrent pulmonary infections his whole life together with difficulties gaining weight. He's a non-smoker with a clear family history and he admits inhalers haven't helped him in the past. He is finally suspected of having cystic fibrosis. What is the normal function of the cystic fibrosis transmembrane regulator?

      Your Answer: Chloride channel

      Explanation:

      Chloride channels are involved in a diverse set of functions in normal physiology and acquired diseases. Additionally, there are genetic diseases caused by mutations in chloride channels (channelopathies) — the most common being cystic fibrosis, which has a prevalence of 1 in 2,000 Caucasians.

    • This question is part of the following fields:

      • Clinical Sciences
      7.6
      Seconds
  • Question 11 - Which one of the following immunological changes is seen in progressive HIV infection?...

    Correct

    • Which one of the following immunological changes is seen in progressive HIV infection?

      Your Answer: Increase in B2-microglobulin levels

      Explanation:

      The immunological changes in HIV include depletion in CD4+ T cell, cytokine dysregulation and immune dysfunction. The dominant immunologic feature of HIV infection is progressive depletion of the helper T cell (CD4+ T cell), which reverses the normal CD4:CD8 ratio and subsequently lead to immunodeficiency. Other imuunological changes include:
      increased B2-microglobulin
      decreased IL-2 production
      polyclonal B-cell activation
      decreased NK cell function
      reduced delayed hypersensitivity responses

    • This question is part of the following fields:

      • Clinical Sciences
      8.9
      Seconds
  • Question 12 - Through which foramen does the maxillary nerve pass through? ...

    Incorrect

    • Through which foramen does the maxillary nerve pass through?

      Your Answer: Superior orbital fissure

      Correct Answer: Foramen rotundum

      Explanation:

      The foramen rotundum is one of the several circular apertures (the foramina) located in the base of the skull, in the anterior and medial part of the sphenoid bone. The maxillary branch (V2) of the trigeminal nerve (CN V) passes through and exits the skull via the pterygopalatine fossa and the foramen rotundum.

    • This question is part of the following fields:

      • Clinical Sciences
      14
      Seconds
  • Question 13 - Choose the correct statement regarding hyponatremia: ...

    Correct

    • Choose the correct statement regarding hyponatremia:

      Your Answer: Hyperlipidaemia may cause pseudohyponatraemia

      Explanation:

      The Hyperlipidaemia Effect: Pseudohyponatremia in Pancreatic Cancer; Patients who have disorders of cholestasis commonly present with volume depletion due to vomiting and poor oral intake, which, in turn, often leads to hypovolemic hyponatremia. It is less well known that disorders of cholestasis, including tumours of the hepatobiliary system, can be accompanied by hyperlipidaemia.

    • This question is part of the following fields:

      • Clinical Sciences
      76.4
      Seconds
  • Question 14 - Where is secretin secreted from? ...

    Correct

    • Where is secretin secreted from?

      Your Answer: S cells in upper small intestine

      Explanation:

      Secretin is a peptide hormone produced in the S cells of the duodenum, which are located in the intestinal glands. In humans, the secretin peptide is encoded by the SCT gene.
      Secretin helps regulate the pH of the duodenum by
      1) inhibiting the secretion of gastric acid from the parietal cells of the stomach and
      (2) stimulating the production of bicarbonate from the ductal cells of the pancreas.
      G cells in the antrum of the stomach release gastrin
      I cells in upper small intestine release CCK
      D cells in the pancreas & stomach secrete somatostatin
      K cells secrete gastric inhibitory peptide, an incretin, which also promotes triglyceride storage.

    • This question is part of the following fields:

      • Clinical Sciences
      7.4
      Seconds
  • Question 15 - A 19-year-old woman is admitted with diabetic ketoacidosis (DKA). It is her fourth...

    Correct

    • A 19-year-old woman is admitted with diabetic ketoacidosis (DKA). It is her fourth episode in the past two months and she's known to be a type 1 diabetes mellitus patient. The doctors suspects she's non-compliant with her treatment to keep her weight down. She often self-discharges after 24 hours. What is the single most appropriate management?

      Your Answer: Have a chat after the ward round about why she thinks her control is so bad

      Explanation:

      In many Western countries and health plans in the United States, patients have a primary care physician who acts as a formal gatekeeper for medical specialist care and thereby determines together with the patient whether or not a patient requires medical specialist care. Ideally in such systems, patients are treated in primary care if possible, and referred to medical specialist care if necessary. For the gatekeeper system to be effective, it is vital that adequate decisions are made about when and who to refer. But it is also important that referred patients comply with the referral by consulting a medical specialist. In this case, the GP should discuss with the patient the reasons why she cannot follow the treatment plan. In other words, the GP should detect why the patient is being non-compliant.

    • This question is part of the following fields:

      • Clinical Sciences
      6.2
      Seconds
  • Question 16 - What is the correct formula to calculate the positive predictive value? (TP =...

    Correct

    • What is the correct formula to calculate the positive predictive value? (TP = true positive; FP = false positive; TN = true negative; FN = false negative)

      Your Answer: TP / (TP + FP)

      Explanation:

      Positive predictive value is the probability that subjects with a positive screening test truly have the disease.

      Positive predictive value = true positive / ( true positive + false positive)

    • This question is part of the following fields:

      • Clinical Sciences
      9.6
      Seconds
  • Question 17 - A 29-year-old male patient with a history of three previous chest infections in...

    Incorrect

    • A 29-year-old male patient with a history of three previous chest infections in the past seven months presents with fever, pleuritic pain and productive cough. Chest x-ray shows lobar consolidation and the diagnosis of a fourth chest infection is established, after sputum culture reveals Haemophilus influenzae. The previous chest infections were due to Streptococcus pneumoniae. After a period of six weeks, a full blood count, urea, CRP, electrolytes and chest x-ray turn out as normal. What is the investigation you would choose next?

      Your Answer: HIV test

      Correct Answer: Serum immunoglobulins

      Explanation:

      Hypogammaglobulinemia occurs due to a variety of underlying primary or secondary immunodeficient states, including HIV which is suspected in this case. The most commonly recognised clinical feature is recurrent infection.

    • This question is part of the following fields:

      • Clinical Sciences
      22.7
      Seconds
  • Question 18 - Choose the correct statement regarding endothelin: ...

    Correct

    • Choose the correct statement regarding endothelin:

      Your Answer: Endothelin antagonists are useful in primary pulmonary hypertension

      Explanation:

      Current guidelines recommend the use of ambrisentan, Bosentan (recommendation I, level of evidence A) and macitentan (I, B) in patients with PAH and WHO functional class II and III. In WHO functional class IV, the first-line drug is Epoprostenol and the recommendation for Endothelin receptor antagonists is weaker (IIb, C).

    • This question is part of the following fields:

      • Clinical Sciences
      9
      Seconds
  • Question 19 - Which one of the following cardiac tissue types has the highest conduction velocity?...

    Correct

    • Which one of the following cardiac tissue types has the highest conduction velocity?

      Your Answer: Purkinje fibres

      Explanation:

      Nerve conduction velocity is an important aspect of nerve conduction studies. It is the speed at which an electrochemical impulse propagates down a neural pathway. Ultimately, conduction velocities are specific to each individual and depend largely on an axon’s diameter and the degree to which that axon is myelinated.
      The cardiac action potential is a brief change in voltage (membrane potential) across the cell membrane of heart cells. Conduction speed varies:
      Atrial conduction spreads along ordinary atrial myocardial fibres at 1 m/sec
      AV node conduction 0.05 m/sec
      Ventricular conduction Purkinje fibres are of large diameter and achieve velocities of 2-4 m/sec (this allows a rapid and coordinated contraction of the ventricles.

    • This question is part of the following fields:

      • Clinical Sciences
      3.1
      Seconds
  • Question 20 - Choose the best source of folic acid: ...

    Incorrect

    • Choose the best source of folic acid:

      Your Answer: Red meat

      Correct Answer: Liver

      Explanation:

      Beef liver is one of the best sources of folic acid, amongst others like green vegetables and nuts.

    • This question is part of the following fields:

      • Clinical Sciences
      5.1
      Seconds
  • Question 21 - A 45-year-old woman with a history of hypothyroidism, presents with ptosis and muscle...

    Correct

    • A 45-year-old woman with a history of hypothyroidism, presents with ptosis and muscle weakness. She's noticed that her muscle weakness becomes worse towards the end of the day. Clinical examination reveals fatigable ptosis and proximal limb weakness. Myasthenia gravis is suspected. Which receptor is implicated in the pathophysiology of this condition?

      Your Answer: Nicotinic acetylcholine receptors

      Explanation:

      Myasthenia gravis (MG) is an organ-specific autoimmune disease caused by an antibody-mediated assault on the muscle nicotinic acetylcholine receptor (AChR) at the neuromuscular junction. Binding of antibodies to the AChR leads to loss of functional AChRs and impairs the neuromuscular signal transmission, resulting in muscular weakness.

    • This question is part of the following fields:

      • Clinical Sciences
      23.4
      Seconds
  • Question 22 - Which one of the following congenital infections is most characteristically associated with chorioretinitis?...

    Incorrect

    • Which one of the following congenital infections is most characteristically associated with chorioretinitis?

      Your Answer: Cytomegalovirus

      Correct Answer: Toxoplasma gondii

      Explanation:

      The common congenital infections encountered are rubella, toxoplasmosis and cytomegalovirus. Cytomegalovirus is the most common congenital infection in the UK. Maternal infection is usually asymptomatic.
      Congenital toxoplasmosis is associated with fetal death and abortion, and in infants, it is associated with neurologic deficits, neurocognitive deficits, and chorioretinitis.

    • This question is part of the following fields:

      • Clinical Sciences
      3.9
      Seconds
  • Question 23 - A woman with severe renal failure undergoes a kidney transplant. However, after a...

    Correct

    • A woman with severe renal failure undergoes a kidney transplant. However, after a few hours, she develops fever and anuria. The doctors are suspecting hyperacute organ rejection. Which are the cells primarily responsible for hyperacute organ rejection?

      Your Answer: B Cells

      Explanation:

      Hyperacute rejection appears in the first minutes following transplantation and occurs only in vascularized grafts. This very fast rejection is characterized by vessel thrombosis leading to graft necrosis. Hyperacute rejection is caused by the presence of antidonor antibodies existing in the recipient before transplantation. These antibodies induce both complement activation and stimulation of endothelial cells to secrete Von Willebrand procoagulant factor, resulting in platelet adhesion and aggregation. The result of these series of reactions is the generation of intravascular thrombosis leading to lesion formation and ultimately to graft loss. Today, this type of rejection is avoided in most cases by checking for ABO compatibility and by excluding the presence of antidonor human leukocyte antigen (HLA) antibodies by cross-match techniques between donor graft cells and recipient sera. This type of rejection is also observed in models of xenotransplantation of vascularized organs between phylogenetically distant species when no immunosuppressive treatment is given to the recipients.

    • This question is part of the following fields:

      • Clinical Sciences
      3.5
      Seconds
  • Question 24 - A 23-year-old male patient with a downward dislocation of the lens in his...

    Incorrect

    • A 23-year-old male patient with a downward dislocation of the lens in his right eye is experiencing visual problems. The ophthalmologist notes a constellation of symptoms resembling those of Marfan Syndrome. The patient's history reveals learning disabilities and a diagnosis of homocystinuria is suspected. What is the pathophysiology of homocystinuria?

      Your Answer: Deficiency of homocysteine transsulfurase

      Correct Answer: Deficiency of cystathionine beta synthase

      Explanation:

      Inherited metabolic disorders are often characterized by the lack of an essential enzyme and are currently treated by dietary restriction and other strategies to replace the substrates or products of the missing enzyme. Patients with homocystinuria lack the enzyme cystathionine β-synthase (CBS), and many of these individuals do not respond to current treatment protocols.

    • This question is part of the following fields:

      • Clinical Sciences
      13.7
      Seconds
  • Question 25 - Which one of the following is true regarding Escherichia coli infection? ...

    Correct

    • Which one of the following is true regarding Escherichia coli infection?

      Your Answer: E coli is an important cause of neonatal meningitis

      Explanation:

      Escherichia coli (also known as E. coli) is a gram-negative, facultatively anaerobic, rod-shaped bacterium commonly found in the lower intestine of warm-blooded organisms. Most E. coli strains are harmless, but some serotypes can cause serious food poisoning in their hosts, and are occasionally responsible for product recalls due to food contamination. The harmless strains are part of the normal flora of the gut, and can benefit their hosts by producing vitamin K2, and preventing colonization of the intestine with pathogenic bacteria. Virulent strains can cause gastroenteritis, urinary tract infections, and neonatal meningitis.
      The most common causes of neonatal meningitis is bacterial infection of the blood, known as bacteremia (specifically Group B Streptococci (GBS; Streptococcus agalactiae), Escherichia coli, and Listeria monocytogenes). Although there is a low mortality rate in developed countries, there is a 50% prevalence rate of neurodevelopmental disabilities in E. coli and GBS meningitis

    • This question is part of the following fields:

      • Clinical Sciences
      104
      Seconds
  • Question 26 - A 54-year-old female patient presents with a one week history of bloody diarrhoea,...

    Incorrect

    • A 54-year-old female patient presents with a one week history of bloody diarrhoea, fever and abdominal pain. She has a history of rheumatoid arthritis which she controls with methotrexate. Her stool sample shows Campylobacter jejuni. What is the single most appropriate management?

      Your Answer: Fluids alone

      Correct Answer: Fluids + clarithromycin

      Explanation:

      This woman is receiving methotrexate, an immunosuppressant, to control her rheumatoid arthritis. In such immunocompromised patients, BNF suggests clarithromycin as first-line management.

    • This question is part of the following fields:

      • Clinical Sciences
      9
      Seconds
  • Question 27 - A 62year-old manpresents with exertional chest pain and is found to have extensive...

    Correct

    • A 62year-old manpresents with exertional chest pain and is found to have extensive coronary artery disease on angiogram. Which of the following cell types is most implicated in the development of coronary artery plaques?

      Your Answer: Macrophages

      Explanation:

      An atheroma is an accumulation of degenerative material in the tunica intima (inner layer) of artery walls. The material consists of (mostly) macrophage cells, or debris, containing lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue.

    • This question is part of the following fields:

      • Clinical Sciences
      10.9
      Seconds
  • Question 28 - Choose the most important stimulator of the central chemoreceptors: ...

    Correct

    • Choose the most important stimulator of the central chemoreceptors:

      Your Answer: Decrease in pH

      Explanation:

      Central chemoreception refers to the detection of changes in CO2/H+ within the brain and the associated effects on breathing. In the conscious animal the response of ventilation to changes in the brain’s interstitial fluid (ISF) pH is very sensitive. Note that a small change in cerebrospinal fluid (CSF) pH from 7.30 to 7.25 is associated with a doubling of alveolar ventilation; it is a very sensitive reflex response. Note also that the relationship of alveolar ventilation to ISF pH is essentially the same for both types of stimulation, metabolic acid-base disorders and primary CO2 stimulation.

    • This question is part of the following fields:

      • Clinical Sciences
      6
      Seconds
  • Question 29 - A study is developed to assess a new mandible advancement device designed to...

    Incorrect

    • A study is developed to assess a new mandible advancement device designed to reduce snoring. A 10 point scale was used to assess the severity of snoring before and after applying of the device by the respective partner. The number of the people involved in the study was 50. What test would you apply in this particular study?

      Your Answer: Mann-Whitney test

      Correct Answer: Wilcoxon signed-rank test

      Explanation:

      Steps required in performing the Wilcoxon signed rank test:

      1 State the null hypothesis and, in particular, the hypothesized value for comparison
      2 Rank all observations in increasing order of magnitude, ignoring their sign. Ignore any observations that are equal to the hypothesized value. If two observations have the same magnitude, regardless of sign, then they are given an average ranking
      3 Allocate a sign (+ or -) to each observation according to whether it is greater or less than the hypothesized value (as in the sign test)
      4 Calculate:
      R+ = sum of all positive ranks
      R- = sum of all negative ranks
      R = smaller of R+ and R-
      5 Calculate an appropriate P value What makes this test the most appropriate for this study is that the data is non-parametric, paired and comes from the same population.

    • This question is part of the following fields:

      • Clinical Sciences
      12.8
      Seconds
  • Question 30 - What do T-helper cells of the Th2 subset typically secrete? ...

    Correct

    • What do T-helper cells of the Th2 subset typically secrete?

      Your Answer: IL-4, IL-5, IL-6, IL-10, IL-13

      Explanation:

      Interleukin-4 (IL-4), IL-5 and IL-13, the signature cytokines that are produced during type 2 immune responses, are critical for protective immunity against infections of extracellular parasites and are responsible for asthma and many other allergic inflammatory diseases. Although many immune cell types within the myeloid lineage compartment including basophils, eosinophils and mast cells are capable of producing at least one of these cytokines, the production of these “type 2 immune response-related” cytokines by lymphoid lineages, CD4 T helper 2 (Th2) cells and type 2 innate lymphoid cells (ILC2s) in particular, are the central events during type 2 immune responses.

    • This question is part of the following fields:

      • Clinical Sciences
      20.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Clinical Sciences (20/30) 67%
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