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  • Question 1 - What is the most accurate definition of evidence-based medicine (EBM)? ...

    Correct

    • What is the most accurate definition of evidence-based medicine (EBM)?

      Your Answer: EBM is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients

      Explanation:

      Evidence-Based Medicine

      Evidence-based medicine (EBM) is a widely accepted approach to healthcare decision-making that involves the conscientious, explicit, and judicious use of current best evidence. This approach integrates the best available evidence with individual patient preferences to make informed decisions about patient care. While economic analyses can help allocate resources in a cost-effective manner, critical appraisal of clinical research is also an essential element of EBM.

      EBM recognizes that high-quality randomized controlled trials and systematic reviews are valuable sources of evidence, but they are not the only sources. Practicing according to guidelines can be beneficial if the guidelines are evidence-based, but this is not always the case. Ultimately, the goal of EBM is to provide patients with the best possible care by using the most current and reliable evidence available while taking into account individual patient preferences and characteristics. By doing so, healthcare providers can make informed decisions that lead to better patient outcomes.

    • This question is part of the following fields:

      • Clinical Sciences
      46.9
      Seconds
  • Question 2 - How would a CT scan show the structure located posteriorly to the first...

    Incorrect

    • How would a CT scan show the structure located posteriorly to the first part of the duodenum?

      Your Answer: Abdominal aorta

      Correct Answer: Portal vein

      Explanation:

      Anatomy of the Duodenum

      The duodenum, which is the first part of the small intestine, can be divided into four sections. The posterior relations of the first part of the duodenum include the portal vein, common bile duct, and gastroduodenal artery, with the inferior vena cava located behind them. The third part of the duodenum is crossed by the abdominal aorta, while the superior mesenteric vessels are an anterior relation of this section. The second part of the duodenum is where the main pancreatic duct opens, and it is also crossed by the transverse colon.

    • This question is part of the following fields:

      • Clinical Sciences
      33.5
      Seconds
  • Question 3 - In which cell types can mesenchymal pluripotent stem cells undergo differentiation? ...

    Correct

    • In which cell types can mesenchymal pluripotent stem cells undergo differentiation?

      Your Answer: Osteoblasts, adipocytes and chondrocytes

      Explanation:

      Mesenchymal Stem Cells: A Versatile Type of Connective Tissue

      The mesenchyme is a type of connective tissue that originates from the embryonic mesoderm and is composed of undifferentiated cells. During fetal development, these mesenchymal stem cells differentiate into various types of adult cells, including osteoblasts, adipocytes, and chondrocytes. Mesenchymal stem cells have a remarkable ability to self-renew, making them a valuable resource for regenerative medicine.

      Osteoblasts are cells that generate bone tissue, while adipocytes are responsible for storing fat in the body. Chondrocytes, on the other hand, produce cartilage, which is essential for maintaining healthy joints. These three cell types are the primary products of mesenchymal stem cells.

      It’s important to note that the other answer options are incorrect because they don’t arise from mesenchymal stem cells. Mesenchymal stem cells are a versatile type of connective tissue that holds great promise for treating a wide range of medical conditions.

    • This question is part of the following fields:

      • Clinical Sciences
      55.5
      Seconds
  • Question 4 - Which muscles are responsible for flexing the hip joint? ...

    Correct

    • Which muscles are responsible for flexing the hip joint?

      Your Answer: Psoas

      Explanation:

      Muscles and their Functions in Joint Movement

      The hip joint has three main flexors, namely the iliacus, psoas, and rectus femoris muscles. These muscles are responsible for flexing the hip joint, which is the movement of bringing the thigh towards the abdomen. On the other hand, the gluteus maximus and medius muscles are involved in hip extension, which is the movement of bringing the thigh backward.

      Moving on to the elbow joint, the bicep femoris muscle is one of the primary flexors. This muscle is responsible for bending the elbow, which is the movement of bringing the forearm towards the upper arm. Lastly, the adductor brevis muscle is responsible for adducting the leg at the hip joint, which is the movement of bringing the leg towards the midline of the body.

      In summary, muscles play a crucial role in joint movement. the functions of these muscles can help in identifying and addressing issues related to joint movement and mobility.

    • This question is part of the following fields:

      • Clinical Sciences
      8
      Seconds
  • Question 5 - What structure is located posterior to the femoral artery that you use to...

    Incorrect

    • What structure is located posterior to the femoral artery that you use to compress the artery during examination of the leg?

      Your Answer: Iliac bone

      Correct Answer: Psoas tendon

      Explanation:

      The Femoral Artery and its Relations

      The femoral artery is a major blood vessel that can be felt at the mid inguinal point, which is located halfway between the anterior superior iliac spine and the pubic symphysis. It is the continuation of the external iliac artery and passes through the femoral triangle, where it gives off the deep femoral artery before entering the adductor canal. The femoral artery is located laterally to the femoral nerve and medially to the femoral vein, with the psoas tendon being its posterior relation.

      As the femoral artery continues down the leg, it enters the popliteal fossa and becomes the popliteal artery. This artery is responsible for supplying blood to the lower leg and foot. the location and relations of the femoral artery is important for medical professionals, as it is a common site for arterial catheterization and other procedures. By knowing the anatomy of this artery, healthcare providers can ensure safe and effective treatment for their patients.

    • This question is part of the following fields:

      • Clinical Sciences
      25.6
      Seconds
  • Question 6 - What is the hormone that controls the levels of calcium in the blood?...

    Correct

    • What is the hormone that controls the levels of calcium in the blood?

      Your Answer: Parathyroid hormone

      Explanation:

      The Importance of Parathyroid Hormone in Regulating Blood Calcium Levels

      Calcium plays a crucial role in various bodily functions, including bone support, blood clotting, muscle contraction, nervous transmission, and hormone production. However, excessively high or low levels of calcium in the blood and interstitial fluid can lead to serious health issues such as arrhythmias and cardiac arrest. This is where parathyroid hormone comes in.

      Parathyroid hormone is responsible for regulating blood calcium levels. It works directly on the bone, stimulating bone production or resorption depending on the concentration and duration of exposure. It also acts on the kidney, increasing the loss of phosphate in the urine, decreasing the loss of calcium in the urine, and promoting the activity of the enzyme 1-alpha hydroxylase, which activates vitamin D. Additionally, parathyroid hormone indirectly affects the gut through the action of activated vitamin D.

      Overall, the regulation of blood calcium levels is crucial for maintaining optimal bodily functions. Parathyroid hormone plays a vital role in this process by directly and indirectly affecting various organs and systems in the body.

    • This question is part of the following fields:

      • Clinical Sciences
      8.3
      Seconds
  • Question 7 - What is the full form of ATP and how is it used during...

    Correct

    • What is the full form of ATP and how is it used during exercise?

      Your Answer: Adenosine triphosphate

      Explanation:

      ATP Generation During Exercise

      During exercise, the process of muscle contraction requires the generation of ATP, which stands for adenosine triphosphate. ATP is a small molecule composed of adenine and a sugar group attached to three phosphate groups. When ATP loses a phosphate group, it becomes ADP and releases energy.

      To sustain prolonged exercise, ATP must be regenerated quickly. This is achieved through the creatine phosphate – ATP system. Creatine phosphate releases a phosphate group, which allows for the rapid regeneration of ATP from ADP. This system ensures that the muscles have a constant supply of ATP to support muscle contraction during exercise. Proper ATP generation is crucial for athletes and individuals engaging in physical activity to perform at their best.

    • This question is part of the following fields:

      • Clinical Sciences
      14.8
      Seconds
  • Question 8 - A 48 month study compared two treatments for hypertension in patients over the...

    Correct

    • A 48 month study compared two treatments for hypertension in patients over the age of 60.
      The null hypothesis was that there was no difference between the two treatments.
      The primary outcome was reduction of systolic blood pressure below 140 mmHg. This outcome was reached in 75% of patients taking treatment A and 80% of patients taking treatment B. The results were reported as being significant with a p-value of 0.05.
      What is the correct interpretation of the P value?

      Your Answer: There is a 5% probability of finding this result if there is no difference between the regimens

      Explanation:

      The Misunderstood P Value

      The P value is often misunderstood and over-interpreted. It is important to note that the P value only indicates the probability of obtaining the results by chance if there was no difference between the regimens being compared. It does not provide information on the actual difference between the regimens or the likelihood of one being better than the other. This confusion has led to the increased use of confidence intervals as a more informative measure.

      Goodman SN’s article Toward Evidence-Based Medical Statistics delves deeper into this issue and highlights the fallacy of relying solely on P values. It is crucial to understand the limitations of the P value and to use it in conjunction with other statistical measures to draw accurate conclusions. By doing so, we can ensure that our research is evidence-based and reliable.

    • This question is part of the following fields:

      • Clinical Sciences
      40.4
      Seconds
  • Question 9 - What is the cofactor needed for pyruvate dehydrogenase to operate during the conversion...

    Correct

    • What is the cofactor needed for pyruvate dehydrogenase to operate during the conversion of pyruvate to acetyl CoA at the end of glycolysis?

      Your Answer: Thiamine

      Explanation:

      Pyruvate Dehydrogenase and its Enzyme Complex

      Pyruvate dehydrogenase is an enzyme complex that plays a crucial role in metabolism. It is composed of multiple copies of several enzymes, including E1, E2, and E3. E1, also known as pyruvate dehydrogenase, is located at the periphery of the molecule and requires thiamine pyrophosphate, a derivative of the vitamin thiamine, to function properly. E2, a transacetylase enzyme, is situated in the core of the molecule and requires lipoamide to work effectively. Lipoamide contains a thiol group that enables it to participate in redox reactions. E3, a dehydrogenase enzyme, is located at the periphery of the molecule and requires a molecule of FAD (flavin adenine dinucleotide) to function. Flavin structures are obtained from the vitamin riboflavin in the diet.

      Thiamine is essential for normal pyruvate dehydrogenase activity, and it must be obtained from the diet as the body can only store relatively small amounts. Thiamine deficiency is common and can lead to a range of potentially serious complications, including Wernicke’s encephalopathy, Korsakoff’s psychosis, and peripheral neurological symptoms. Overall, the pyruvate dehydrogenase enzyme complex is under strict metabolic control and plays a critical role in energy production and metabolism.

    • This question is part of the following fields:

      • Clinical Sciences
      16.8
      Seconds
  • Question 10 - A 16-year-old girl is playing volleyball and suffers an anterior dislocation of her...

    Correct

    • A 16-year-old girl is playing volleyball and suffers an anterior dislocation of her right shoulder. She is taken to the Emergency department where her humerus is reduced under sedation. Which area should be tested for sensation to determine the nerve that is most likely to have been affected during the dislocation?

      Your Answer: Regimental badge distribution

      Explanation:

      Nerve Damage from Shoulder Dislocation

      Shoulder dislocation can cause damage to the axillary nerve, which is responsible for supplying sensation to the upper part of the arm. This nerve is the most likely to be affected during a dislocation. The axillary nerve also controls the deltoid muscle, which can be examined to assess motor sensation.

    • This question is part of the following fields:

      • Clinical Sciences
      19.9
      Seconds
  • Question 11 - A 20-year-old rugby player presents with a sore throat, followed by severe malaise,...

    Incorrect

    • A 20-year-old rugby player presents with a sore throat, followed by severe malaise, high fever, and confusion two days later. He had a splenectomy three years ago after rupturing his spleen during a rugby match. The consultant suspects that he may have septicaemia.

      Which organism poses the highest risk to patients who have had their spleen removed?

      Your Answer: Staphylococcus aureus

      Correct Answer: Streptococcus pneumoniae

      Explanation:

      Increased Infection Risk for Patients without a Spleen

      Patients who have had their spleen removed have a weakened immune system, making them less capable of fighting off encapsulated bacteria. This puts them at a higher risk of infection from Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, and Escherichia coli. While it is recommended for these patients to receive vaccinations and sometimes antibiotics, there is still a significant risk of overwhelming post-splenectomy infection (OPSI), with a lifetime risk as high as 4%. Therefore, it is important for patients without a spleen to take extra precautions to prevent infections and seek medical attention promptly if they experience any symptoms.

    • This question is part of the following fields:

      • Clinical Sciences
      30.6
      Seconds
  • Question 12 - A 72-year-old male with a BMI of 31 kg/m2 presents with bilateral lower...

    Correct

    • A 72-year-old male with a BMI of 31 kg/m2 presents with bilateral lower limb cellulitis. A urine dipstick shows glycosuria ++. What test would be most effective in diagnosing type 2 diabetes?

      Your Answer: Fasting blood glucose and HbA1c

      Explanation:

      Diagnosis of Diabetes

      An infection can often lead to the diagnosis of diabetes. To determine if a patient has diabetes, a standard 75 gram glucose load is given and an oral glucose tolerance test is carried out after random and fasting blood glucose tests. It is important to note that a random blood glucose sample may not provide accurate results, and the best way to diagnose type 2 diabetes in a patient is through a fasting glucose test. However, an HbA1c test is now widely accepted as a standard test for diagnosing diabetes and is used in place of fasting blood glucose by some healthcare professionals. It is important to accurately diagnose diabetes in patients to ensure proper treatment and management of the condition.

    • This question is part of the following fields:

      • Clinical Sciences
      19.8
      Seconds
  • Question 13 - A study recruits a random sample of 5,000 individuals over the age of...

    Correct

    • A study recruits a random sample of 5,000 individuals over the age of 50 and asks about their use of herbs and other health supplements. Participants are then followed-up for five years. The study aims to compare the incidence of colon cancer among participants to see if the use of herbs or health supplements has any effect.

      What type of study is this?

      Your Answer: Cohort study

      Explanation:

      Different Types of Studies

      When it comes to conducting research, it is important to understand the characteristics of different types of studies as they serve different purposes. For instance, a cohort study is typically used to investigate risk factors of diseases. On the other hand, a case-control study begins with identifying cases of a particular disease and controls who are not affected. Unlike a cohort study, a case-control study does not require waiting for the occurrence of the disease.

      Qualitative studies, on the other hand, are used to explore variables that are not easily quantifiable, such as opinions and thoughts of patients. These studies are not suitable for studying the incidence and risk of diseases. Lastly, a randomized controlled trial involves researchers assigning treatment instead of participants choosing their own treatment.

      In summary, the characteristics of different types of studies is crucial in selecting the appropriate research method for a particular research question.

    • This question is part of the following fields:

      • Clinical Sciences
      24.5
      Seconds
  • Question 14 - A 12-year-old girl is experiencing intense pain around her belly button that is...

    Correct

    • A 12-year-old girl is experiencing intense pain around her belly button that is spreading to her right iliac fossa. She has a fever and is vomiting on and off. The medical team has decided to perform a laparoscopic removal of her appendix. Can you identify the most frequent location of the appendix in the pelvis?

      Your Answer: Retrocaecal

      Explanation:

      Anatomy of the Appendix

      The appendix is a tube that is approximately 10 cm long and can be found in different positions in the body depending on the individual. It is most commonly located behind the caecum, which is retrocaecal, in about 65% of people. However, it can also be found in the pelvic area in around 30% of individuals. Other variations include being located below the caecum, which is subcaecal, or in front of the terminal ileum, which is pre-ileal. Additionally, it can be found behind the ileum, which is post-ileal. The position of the appendix can vary greatly from person to person, and it is important for medical professionals to be aware of these variations when diagnosing and treating conditions related to the appendix.

    • This question is part of the following fields:

      • Clinical Sciences
      34.6
      Seconds
  • Question 15 - What is the definition of kwashiorkor? ...

    Correct

    • What is the definition of kwashiorkor?

      Your Answer: Inadequate protein intake

      Explanation:

      Malnutrition: Types and Causes

      Malnutrition is a condition that can refer to both overnutrition (obesity) and undernutrition, but it is commonly used to describe the latter. Undernutrition can take different forms, with protein-energy malnutrition (PEM) being the most common. PEM can be further classified into kwashiorkor and marasmus, which are characterized by protein deficiency and inadequate consumption of both energy and protein, respectively. Kwashiorkor is associated with oedema, abdominal swelling, and fat accumulation in the liver, while marasmus leads to emaciation without oedema or abdominal swelling.

      Despite being distinct clinical scenarios, kwashiorkor and marasmus are both types of protein-energy undernutrition. It is not clear why some patients develop one form of undernutrition over the other, even when they have similar diets. Malnutrition can also result from isolated vitamin or mineral deficiencies. the different types and causes of malnutrition is crucial in addressing this global health issue.

    • This question is part of the following fields:

      • Clinical Sciences
      11.6
      Seconds
  • Question 16 - A 56-year-old man with advanced motor neuron disease is experiencing difficulty breathing, possibly...

    Incorrect

    • A 56-year-old man with advanced motor neuron disease is experiencing difficulty breathing, possibly due to weakened respiratory muscles.

      Which skeletal muscle is not fully utilized during inspiration?

      Your Answer: Diaphragm

      Correct Answer: Internal intercostals

      Explanation:

      The Muscles Involved in Breathing

      Breathing is a complex process that involves the contraction and relaxation of various muscles. The primary muscles responsible for inspiration are the external intercostal muscles and the diaphragm. These muscles work together to expand the chest cavity and create a negative pressure gradient, allowing air to flow into the lungs. In addition to these primary muscles, the sternocleidomastoid and the scalenes can also assist with inspiration.

      During quiet expiration, the lungs simply recoil back to their resting position due to their elastic properties. However, during forced expiration, the internal intercostal muscles come into play. These muscles contract to decrease the size of the chest cavity and increase the pressure within the lungs, forcing air out.

      the muscles involved in breathing is important for individuals with respiratory conditions, as well as athletes and performers who rely on proper breathing techniques for optimal performance. By strengthening and training these muscles, individuals can improve their breathing efficiency and overall respiratory health.

    • This question is part of the following fields:

      • Clinical Sciences
      32.5
      Seconds
  • Question 17 - In which location do most intracerebral hemorrhages take place? ...

    Incorrect

    • In which location do most intracerebral hemorrhages take place?

      Your Answer: Pre-frontal cortex

      Correct Answer: Basal ganglia

      Explanation:

      Types and Locations of Intracranial Bleeds

      Intracranial bleeds refer to any type of bleeding that occurs within the cranium. There are four main types of intracranial bleeds: extradural, subdural, subarachnoid, and intracerebral. Extradural bleeds occur outside the periosteal dura mater, while subdural bleeds occur between the meningeal dura mater and arachnoid mater. Subarachnoid bleeds occur between the arachnoid mater and pia mater, where cerebrospinal fluid circulates. Intracerebral bleeds, on the other hand, occur within the cerebral tissue itself.

      Of all the types of intracranial bleeds, intracerebral bleeds are the most common. They typically occur deep within the cerebral hemispheres, affecting the basal ganglia, such as the caudate nucleus and putamen. These types of bleeds are usually caused by hypertension, rather than trauma or atherosclerosis. While it is possible for bleeds to occur in any area of the brain, those that occur in the brainstem are particularly debilitating.

    • This question is part of the following fields:

      • Clinical Sciences
      17
      Seconds
  • Question 18 - What is the daily recommended amount of carbohydrates to consume? ...

    Incorrect

    • What is the daily recommended amount of carbohydrates to consume?

      Your Answer: 200 g

      Correct Answer: 50 g

      Explanation:

      The Importance of Carbohydrates in the Diet

      Carbohydrates are essential for the body as they provide fuel for the brain, red blood cells, and the renal medulla. Although the average daily intake of carbohydrates is around 180 g/day, the body can function on a much lower intake of 30-50 g/day. During pregnancy or lactation, the recommended minimum daily requirement of carbohydrates increases to around 100 g/day.

      When carbohydrate intake is restricted, the body can produce glucose through gluconeogenesis, which is the process of making glucose from other fuel sources such as protein and fat. However, when carbohydrate intake is inadequate, the body produces ketones during the oxidation of fats. While ketones can be used by the brain as an alternative fuel source to glucose, prolonged or excessive reliance on ketones can lead to undesirable side effects. Ketones are acidic and can cause systemic acidosis.

      It is important to note that most people consume 200-400 g/day of carbohydrates, which is much higher than the recommended minimum daily requirement. Therefore, it is essential to maintain a balanced diet that includes carbohydrates in the appropriate amount to ensure optimal health.

    • This question is part of the following fields:

      • Clinical Sciences
      8.4
      Seconds
  • Question 19 - A 10-year-old boy comes to the clinic complaining of an itchy right ear...

    Correct

    • A 10-year-old boy comes to the clinic complaining of an itchy right ear that has been bothering him for the past five days. During the examination, he winces in pain when the outer ear is touched. Can you identify which part of the ear is considered the outer ear?

      Your Answer: Pinna

      Explanation:

      Earache: Types and Anatomy of the Ear

      Earache can be categorized into two types: otitis media and otitis externa. Otitis media refers to the inflammation of the middle ear, while otitis externa is the inflammation of the outer ear and/or canal. Pain on touch or gentle pulling of the outer ear is commonly associated with otitis externa.

      The outer ear is composed of the visible part of the ear, called the pinna, and the external auditory meatus near the tragus. The external auditory meatus extends from the pinna around 26 mm to the tympanic membrane. On the other hand, the middle ear reaches from the tympanic membrane to the oval window of the cochlea. This space contains three ossicles, namely the malleus, incus, and stapes, which transmit sound waves to the inner ear.

      The inner ear is made up of the cochlea, which is responsible for hearing, and the vestibular apparatus, which helps maintain balance. The vestibular apparatus consists of three semicircular canals and the vestibule.

      the anatomy of the ear and the different types of earache can help in identifying and treating ear problems. It is important to seek medical attention if experiencing ear pain or discomfort.

    • This question is part of the following fields:

      • Clinical Sciences
      32.2
      Seconds
  • Question 20 - What is the name of the intercellular junctional mechanism that allows cells to...

    Incorrect

    • What is the name of the intercellular junctional mechanism that allows cells to be electrically connected?

      Your Answer:

      Correct Answer: Gap junction

      Explanation:

      Cell Junctions: Types and Functions

      Gap junctions are found where two adjacent cell membranes meet, allowing for electrical communication between cells. Desmosomes are specialized proteins that help cells stick together, particularly in epithelial tissue. Tight junctions prevent water and solutes from leaking out of cells. Zonula adherens junctions are cell junctions that connect to the actin cytoskeleton. These different types of cell junctions play important roles in maintaining the structure and function of tissues in the body.

    • This question is part of the following fields:

      • Clinical Sciences
      0
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SESSION STATS - PERFORMANCE PER SPECIALTY

Clinical Sciences (13/19) 68%
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