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  • Question 1 - Regarding chemical control of respiration, which of the following statements is INCORRECT: ...

    Correct

    • Regarding chemical control of respiration, which of the following statements is INCORRECT:

      Your Answer: The blood-brain barrier is freely permeable to HCO3 - ions.

      Explanation:

      CSF is separated from the blood by the blood-brain barrier. This barrier is impermeable to polar molecules such as H+and HCO3-but CO2can diffuse across it easily. The pH of CSF is therefore determined by the arterial PCO2and the CSF HCO3-and is not affected by blood pH.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      539.7
      Seconds
  • Question 2 - Which of the following tracts must be affected if a patient presents with...

    Incorrect

    • Which of the following tracts must be affected if a patient presents with decreased pain and temperature sensation in both lower extremities?

      Your Answer: The corticospinal tracts

      Correct Answer: The lateral spinothalamic tract

      Explanation:

      The main function of the spinothalamic tract is to carry pain and temperature via the lateral part of the pathway and crude touch via the anterior part. The spinothalamic tract pathway is an imperative sensory pathway in human survival because it enables one to move away from noxious stimuli by carrying pain and temperature information from the skin to the thalamus where it is processed and transmitted to the primary sensory cortex. The primary sensory cortex communicates with the primary motor cortex, which lies close to it, to generate rapid movement in response to potentially harmful stimuli. Furthermore, the spinothalamic tract has a role in responding to pruritogens, causing us to itch. Interestingly, itching suppresses the spinothalamic tract neuron response to the histamine effect.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      82.7
      Seconds
  • Question 3 - Regarding antacids, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Antacids increase absorption of digoxin.

      Correct Answer: Antacids are contraindicated in hypophosphataemia.

      Explanation:

      Antacids are contraindicated in hypophosphataemia. Liquid preparations are more effective than tablet preparations. Magnesium-containing antacids tend to be laxative whereas aluminium-containing antacids tend to be constipating. Antacids are best taken when symptoms occur or are expected, usually between meals and at bedtime. Antacids should preferably not be taken at the same time as other drugs since they may impair absorption.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      65.1
      Seconds
  • Question 4 - You note that the prostate of a 60-year-old patient is enlarged during the...

    Incorrect

    • You note that the prostate of a 60-year-old patient is enlarged during the examination. You suspect BPH. Anatomically, the prostate has four main lobes. Which of the lobes is affected by benign prostatic hypertrophy?

      Your Answer: Anterior lobe

      Correct Answer: Median lobe

      Explanation:

      Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is characterized by an enlarged prostate gland. The prostate is divided into four major lobes. The median lobe is the most commonly affected by benign prostatic enlargement, resulting in urethral obstruction and urine symptoms.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      10.3
      Seconds
  • Question 5 - Which of the following is NOT a typical feature of a lesion to...

    Correct

    • Which of the following is NOT a typical feature of a lesion to the vestibulocochlear nerve:

      Your Answer: Hyperacusis

      Explanation:

      Hyperacusis is increased acuity of hearing with hypersensitivity to low tones resulting from paralysis of the stapedius muscle, innervated by the facial nerve. General sensation to the face and to the anterior two-thirds of the tongue is carried by the divisions of the trigeminal nerve (although taste to the anterior two-thirds of the tongue is supplied by the facial nerve). Eye movements are mediated by the oculomotor, trochlear and abducens nerve. Ptosis results from paralysis of the levator palpebrae superioris, innervated by the oculomotor nerve, or the superior tarsal muscle, innervated by the sympathetic chain.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      10
      Seconds
  • Question 6 - A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a...

    Correct

    • A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a course of antibioticsWhich of the antibiotics listed below is MOST likely to be the cause? 

      Your Answer: Ciprofloxacin

      Explanation:

      Tendinopathy and spontaneous tendon rupture are caused by fluoroquinolones, which are an uncommon but well-known cause. Tendon problems caused by fluoroquinolones are expected to affect 15 to 20 people per 100,000. Patients over the age of 60 are most likely to develop them.It usually affects the Achilles tendon, but it has also been described in cases involving the quadriceps, peroneus brevis, extensor pollicis longus, long head of biceps brachii, and rotator cuff tendons. The exact aetiology is uncertain, although the fluoroquinolone medication is thought to obstruct collagen activity and/or cut off blood supply to the tendon.Other factors linked to tendon rupture spontaneously include:GoutTreatment with corticosteroidsHypercholesterolaemiaLong-term dialysisKidney transplantRheumatoid arthritis 

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      7.4
      Seconds
  • Question 7 - Which of the following clinical features is a feature of a chronic extravascular...

    Incorrect

    • Which of the following clinical features is a feature of a chronic extravascular haemolytic anaemia:

      Your Answer: Raised serum conjugated bilirubin

      Correct Answer: Gallstones

      Explanation:

      Clinical features of haemolytic anaemia include:AnaemiaJaundice (caused by unconjugated bilirubin in plasma, bilirubin is absent from urine)Pigment gallstonesSplenomegalyAnkle ulcersExpansion of marrow with, in children, bone expansion e.g. frontal bossing in beta-thalassaemia majorAplastic crisis caused by parvovirus

    • This question is part of the following fields:

      • Haematology
      • Pathology
      51.8
      Seconds
  • Question 8 - Which of the following conditions manifests hyperkalaemia as one of its symptoms? ...

    Incorrect

    • Which of the following conditions manifests hyperkalaemia as one of its symptoms?

      Your Answer: Type 1 renal tubular acidosis

      Correct Answer: Congenital adrenal hyperplasia

      Explanation:

      Plasma potassium greater than 5.5 mmol/L is hyperkalaemia or elevated plasma potassium level. Among the causes of hyperkalaemia include congenital adrenal hyperplasia. Congenital adrenal hyperplasia is a general term referring to autosomal recessive disorders involving a deficiency of an enzyme needed in cortisol and/or aldosterone synthesis. The level of cortisol and/or aldosterone deficiency affects the clinical manifestations of congenital adrenal hyperplasia. When it involves hypoaldosteronism, it can result in hyponatremia and hyperkalaemia. While hypercortisolism can cause hypoglycaemia.The other causes of hyperkalaemia may include renal failure, excess potassium supplementation, Addison’s disease (adrenal insufficiency), renal tubular acidosis (type 4), rhabdomyolysis, burns, trauma, Tumour lysis syndrome, acidosis, and medications such as ACE inhibitors, angiotensin receptor blockers, NSAIDs, beta-blockers, digoxin, and suxamethonium. Bartter’s syndrome is characterized by hypokalaemic alkalosis with normal to low blood pressure. Type 1 and 2 renal tubular acidosis both cause hypokalaemia. Gitelman’s syndrome is a defect of the distal convoluted tubule of the kidney. It causes metabolic alkalosis with hypokalaemia and hypomagnesemia. And excessive liquorice ingestion causes hypermineralocorticoidism and hypokalaemia as well. Thus, among the choices, only congenital adrenal hyperplasia can cause hyperkalaemia.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      100.9
      Seconds
  • Question 9 - Which of the following is NOT a contraindication to treatment with aspirin at...

    Correct

    • Which of the following is NOT a contraindication to treatment with aspirin at analgesic doses:

      Your Answer: Myasthenia gravis

      Explanation:

      Aspirin (at analgesic doses) is contraindicated in:People with a history of true hypersensitivity to aspirin or salicylates (symptoms of hypersensitivity to aspirin or salicylates include bronchospasm, urticaria, angioedema, and vasomotor rhinitis)People with active or previous peptic ulcerationPeople with haemophilia or another bleeding disorderChildren younger than 16 years of age (risk of Reye’s syndrome)People with severe cardiac failurePeople with severe hepatic impairmentPeople with severe renal impairmentN.B. Owing to an association with Reye’s syndrome, aspirin-containing preparations should not be given to children under 16 years, unless specifically indicated, e.g. for Kawasaki disease.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      12.9
      Seconds
  • Question 10 - You're taking a history of a 59-year-old banker who has had heartburn in...

    Correct

    • You're taking a history of a 59-year-old banker who has had heartburn in the past.Which of the following information about antacids is correct?

      Your Answer: Magnesium carbonate can reduce the absorption of drugs taken at the same time

      Explanation:

      Antacids such as aluminium hydroxide and magnesium carbonate are commonly used. They’re both water-insoluble and can reduce the absorption of drugs taken together. Allow at least 1-2 hours between taking these antacids and any other medications.Because it reduces gastrointestinal phosphate absorption, aluminium hydroxide can also be used to treat hyperphosphatemia in patients with renal failure.Magnesium carbonate has a laxative effect, whereas aluminium hydroxide has a constipating effect.

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      23.4
      Seconds
  • Question 11 - An analytical study is conducted to compare the risk of stroke between Ticagrelor...

    Incorrect

    • An analytical study is conducted to compare the risk of stroke between Ticagrelor therapy and Warfarin therapy among patients with atrial fibrillation. The following is obtained from the study:No. of patients who took Ticagrelor: 300No. of patients who took Ticagrelor and suffered a stroke: 30No. of patients who took Warfarin: 500No. of patients who took Warfarin and suffered a stroke: 20Compute for the risk ratio of a stroke.

      Your Answer: 0.06

      Correct Answer: 2.5

      Explanation:

      Relative risk (RR) is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.RR can be computed as the absolute risk of events in the treatment group (ART), divided by the absolute risk of events in the control group (ARC).RR = ART/ARCRR = (30/300) / (20/500)RR = 2.5Recall that:If RR < 1, then the intervention reduces the risk of the outcome.If RR = 1, then the treatment has no effect on the outcome.If RR > 1, then the intervention increases the risk of the outcome.

    • This question is part of the following fields:

      • Evidence Based Medicine
      72.5
      Seconds
  • Question 12 - A 18 year old student presents to ED with a headache, fever and...

    Correct

    • A 18 year old student presents to ED with a headache, fever and photophobia. You suspect meningitis and agree to observe your junior performing a lumbar puncture. What is the highest safest vertebral level to perform lumbar puncture in adults:

      Your Answer: L3/L4

      Explanation:

      In adults, the spinal cord typically ends between L1/L2 whereas the subarachnoid space extends to approximately the lower border of vertebra S2. Lumbar puncture is performed in the intervertebral space L4/L5 or L3/L4.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      188.9
      Seconds
  • Question 13 - Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic...

    Incorrect

    • Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels. The phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.A phenylalkylamine calcium-channel blocker is, for example, which of the following?

      Your Answer: Diltiazem

      Correct Answer: Verapamil

      Explanation:

      Calcium-channel blockers, also known as calcium antagonists, stop calcium from entering cells through the L-type calcium channel. This causes vascular smooth muscle in vessel walls to relax, resulting in a decrease in peripheral vascular resistance. They can be used for a variety of things, including:HypertensionAnginaAtrial fibrillationMigraineCalcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels.Dihydropyridines have a high vascular selectivity and lower systemic vascular resistance and blood pressure. As a result, they’re frequently used to treat hypertension. Modified release formulations are also used to treat angina, but their powerful systemic vasodilator and pressure-lowering effects can cause reflex cardiac stimulation, resulting in increased inotropy and tachycardia, which can counteract the beneficial effects of reduced afterload on myocardial oxygen demand.The suffix -dpine distinguishes dihydropyridines from other pyridines. Examples of dihydropyridines that are commonly prescribed include:AmlodipineFelodipineNifedipineNimodipineThe phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.Phenylalkylamines are less effective as systemic vasodilators because they are relatively selective for the myocardium. This group of drugs lowers myocardial oxygen demand and reverses coronary vasospasm, making them useful in the treatment of angina. They are also occasionally used to treat arrhythmias. A phenylalkylamine calcium-channel blocker like verapamil is an example.In terms of selectivity for vascular calcium channels, benzothiazepines fall somewhere between dihydropyridines and phenylalkylamines. They can lower arterial pressure without producing the same level of reflex cardiac stimulation as dihydropyridines because they have both cardiac depressant and vasodilator effects. Diltiazem is the only benzothiazepine currently in clinical use.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      84.6
      Seconds
  • Question 14 - A patient is sent in to ED by her GP with hyponatraemia and...

    Incorrect

    • A patient is sent in to ED by her GP with hyponatraemia and hyperkalaemia. There is most likely to be a deficiency in which of the following hormones:

      Your Answer: Cortisol

      Correct Answer: Aldosterone

      Explanation:

      A deficiency of aldosterone, as seen in adrenal insufficiency, can result in hyponatraemia and hyperkalaemia.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      20.9
      Seconds
  • Question 15 - A 40-year-old male visits his family physician with the complaint of a high-grade...

    Incorrect

    • A 40-year-old male visits his family physician with the complaint of a high-grade fever for the past five days. A complete blood count report shows the presence of neutrophilia. Which one of the following facts regarding neutrophilia is accurate?

      Your Answer: Acute neutrophilia is associated with a ‘right shift’

      Correct Answer: It can be caused by eclampsia

      Explanation:

      A total neutrophil count of greater than 7.5 x 109/L is called neutrophilia. Typhoid fever usually causes leukopenia or neutropenia. Both localised and generalised bacterial infections can cause neutrophilia. Metabolic disorders such as – gout- eclampsia- uraemia can also cause neutrophilia. Acute neutrophilia, in which immature neutrophils can be seen, is referred to as a left shift and can be seen in conditions such as appendicitis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      32.2
      Seconds
  • Question 16 - The normal range of arterial HCO3- is: ...

    Incorrect

    • The normal range of arterial HCO3- is:

      Your Answer: 18 - 25 mmol/L

      Correct Answer: 24 - 30 mmol/L

      Explanation:

      Normal ranges:pH = 7.35 – 7.45pO2(on air) = 11 -14 kPapCO2= 4.5 – 6.0 kPaHCO3-= 24 – 30 mmol/LBE = +/- 2 mmol/L

    • This question is part of the following fields:

      • Physiology
      • Renal
      8.8
      Seconds
  • Question 17 - In ventricular myocytes, the plateau phase of the action potential comes about through which...

    Incorrect

    • In ventricular myocytes, the plateau phase of the action potential comes about through which of the following:

      Your Answer: Opening of voltage-gated Na + channels

      Correct Answer: Opening of voltage-gated Ca 2+ channels

      Explanation:

      After the intial upstroke of the action potential, Na+channels and currents rapidly inactivate, but in cardiac myocytes, the initial depolarisation activates voltage-gated Ca2+channels (slow L-type channels, threshold approximately – 45 mV) through which Ca2+floods into the cell. The resulting influx of Ca2+prevents the cell from repolarising and causes a plateau phase, that is maintained for about 250 ms until the L-type channels inactivate. The cardiac AP is thus much longer than that in nerve or skeletal muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      18.1
      Seconds
  • Question 18 - A 21-year-old student presents to the minors area of your Emergency Department with...

    Correct

    • A 21-year-old student presents to the minors area of your Emergency Department with a laceration on his external nose that occurred during sparring in a kickboxing class. The area is bleeding profusely and will require suturing. Pressure is being applied. The laceration extends through some of the nasal muscles.Motor innervation of the nasal muscles of facial expression is provided by which of the following ? Select ONE answer only.

      Your Answer: Facial nerve

      Explanation:

      The facial nerve (the labyrinthine segment) is the seventh cranial nerve, or simply CN VII. It emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue.Motor innervation of the nasal muscles of facial expression is provided by the facial nerve (CN VII).

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      30.3
      Seconds
  • Question 19 - Where: Capillary hydrostatic pressure is (P c) Hydrostatic pressure in the interstices is (P I...

    Incorrect

    • Where: Capillary hydrostatic pressure is (P c) Hydrostatic pressure in the interstices is (P I )Plasma oncotic pressure is (Ï€ p) Interstitial oncotic pressure is (Ï€ i)Which of the following formulas best represents fluid flow at the capillary bed?

      Your Answer: Volume / min = (π p - π i ) + (P c - P i )

      Correct Answer: Volume / min = (P c - P i ) - (π p - π i )

      Explanation:

      Starling’s equation for fluid filtration describes fluid flow at the capillary bed.Filtration forces (capillary hydrostatic pressure and interstitial oncotic pressure) stimulate fluid movement out of the capillary, while resorption forces promote fluid movement into the capillary (interstitial hydrostatic pressure and plasma oncotic pressure). Although the forces fluctuate along the length of the capillary bed, overall filtration is achieved.At the capillary bed, there is fluid movement.The reflection coefficient (σ), the surface area accessible (S), and the hydraulic conductance of the wall (Lp) are frequently used to account for the endothelium’s semi-permeability, yielding:Volume / min = LpS [(Pc- Pi) –  σ(Ï€p– Ï€i)]Volume /min = (Pc-Pi) – (Ï€p–πi) describes the fluid circulation at the capillaries.Where:Pc= capillary hydrostatic pressurePi= interstitial hydrostatic pressureÏ€p= plasma oncotic pressureÏ€i= interstitial oncotic pressure

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      195
      Seconds
  • Question 20 - You examine a 43-year-old woman who was referred to you by a friend....

    Incorrect

    • You examine a 43-year-old woman who was referred to you by a friend. She suffers from a variety of medical conditions and takes a variety of medications, including amitriptyline.Which of the following is NOT a contraindication to amitriptyline treatment?

      Your Answer: Acute porphyria

      Correct Answer: Breastfeeding

      Explanation:

      Amitriptyline is a tricyclic antidepressant (TCA) that is most commonly used to treat depression, but it can also be used to treat anxiety disorders, chronic pain, and attention deficit hyperactivity disorder (ADHD). It inhibits reuptake, raising serotonin and noradrenaline levels while also inhibiting acetylcholine action.TCAs have a number of drawbacks, including:Acute PorphyriaArrhythmiasDuring bipolar disorder’s manic phaseHeart blockAfter a myocardial infarction, there is an immediate recovery period.TCA levels in breast milk are too low to be harmful, and use can be continued while breastfeeding.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      32.1
      Seconds
  • Question 21 - Caseous necrosis is typically seen in which of the following: ...

    Correct

    • Caseous necrosis is typically seen in which of the following:

      Your Answer: Tuberculosis

      Explanation:

      Caseous necrosis is most commonly seen in tuberculosis. Histologically, the complete loss of normal tissue architecture is replaced by amorphous, granular and eosinophilic tissue with a variable amount of fat and an appearance reminiscent of cottage cheese.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      6.3
      Seconds
  • Question 22 - A 17-year-old male patient diagnosed with cystic fibrosis is experiencing shortness of breath,...

    Incorrect

    • A 17-year-old male patient diagnosed with cystic fibrosis is experiencing shortness of breath, coughing, and flu-like symptoms. His X-ray results shows atelectasis, or collapsed lung, specifically in his lower right lung. All of the following statements are true regarding collapsed lungs, except for which one.

      Your Answer: Pulmonary capillary blood will have similar PO 2 and PCO 2

      Correct Answer: Atelectasis is an example of a perfusion defect

      Explanation:

      Atelectasis is a complete or partial collapse of the lung. It occurs when the alveoli deflate or are filled with alveolar fluid. It is considered a ventilation defect of the alveoli due to cystic fibrosis. It is not a perfusion defect. A perfusion defect will produce pathological dead space in which the lung alveoli are ventilated adequately but are not perfused, and there is no gas exchange. While with atelectasis, the alveoli remain perfused. However, there is impaired oxygen delivery and intrapulmonary shunting of blood will be present in the collapsed area. Since there is no exchange of gas at the capillary-alveolar interface of the collapsed segments, the pulmonary capillary blood will have similar PO2 and PCO2.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      33.6
      Seconds
  • Question 23 - Regarding bile, which of the following statements is CORRECT: ...

    Correct

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

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

      Explanation:

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

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      65.7
      Seconds
  • Question 24 - A 61-year-old woman returns to get the results of recent blood tests she...

    Incorrect

    • A 61-year-old woman returns to get the results of recent blood tests she had done for non-specific malaise, lethargy, and weight loss. The only abnormality discovered during the blood tests was a 580 x 10 9 /l increase in platelets. Her platelets were also elevated on a blood test taken 6 months earlier, according to her previous results. You're aware of the recent emergence of elevated platelet levels as a cancer risk marker and decide to look into it.Which of the following cancers is most likely to cause isolated thrombocytosis?

      Your Answer: Multiple myeloma

      Correct Answer: Colorectal cancer

      Explanation:

      Raised platelet levels have emerged as a cancer risk marker, according to a large population-based study published in 2017(link is external). According to the study, 12 percent of men and 6% of women with thrombocytosis were diagnosed with cancer within a year. These figures increased to 18% in men and 10% in women if a second platelet count was taken within 6 months of the first and showed an increased or stable elevated platelet count.The researchers discovered that thrombocytosis linked to cancer is most common in colorectal and lung cancers, and it is linked to a worse prognosis. Furthermore, one-third of the cancer patients in the study had no other symptoms that would have prompted an immediate cancer referral.The exact mechanism by which these cancers cause thrombocytosis is unknown, but one theory proposes the existence of pathogenic feedback loops between malignant cells and platelets, with a reciprocal interaction between tumour growth and metastasis, as well as thrombocytosis and platelet activation. Another hypothesis is that thrombocytosis occurs independently of cancer but aids in its spread and progression.The findings show that routinely testing for thrombocytosis could cut the time it takes to diagnose colorectal and lung cancer by at least two months. In the UK, this could result in around 5500 earlier cancer diagnoses per year.Because the positive predictive value of thrombocytosis in middle age for cancer (10%) is higher than the positive predictive value for a woman in her 50s presenting with a new breast lump (8.5%), this is clearly an important research paper that should be used to adjust future clinical practise. The current NICE guidelines predate these new research findings, so we’ll have to wait and see how they affect cancer referral guidelines in the UK.Because there are so many possible cancers associated with thrombocytosis, the treating clinician should take a thorough history and perform a thorough clinical examination if a patient is diagnosed with it. Further investigation and the most appropriate referral route should be aided by this information.It’s worth noting that the patients in the study had their blood tests done for a medical reason rather than as a random screening test.If there are no other symptoms to guide investigation and referral (one-third of the patients in the study had no other symptoms), keep in mind that the two most common cancers encountered were colorectal and lung cancer, so a chest X-ray and a faecal immunochemical test (FIT) for faecal blood may be reasonable initial investigations.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      33.7
      Seconds
  • Question 25 - Regarding flow through a tube, which of the following statements is CORRECT: ...

    Correct

    • Regarding flow through a tube, which of the following statements is CORRECT:

      Your Answer: Polycythaemia will decrease the rate of blood flow through a vessel.

      Explanation:

      Darcy’s law states that flow through a tube is dependent on the pressure differences across the ends of the tube (P1 – P2) and the resistance to flow provided by the tube (R). Resistance is due to frictional forces and is determined by the length of the tube (L), the radius of the tube (r) and the viscosity of the fluid flowing down that tube (V). The radius of the tube has the largest effect on resistance and therefore flow – this explains why smaller gauge cannulas with larger diameters have a faster rate of flow. Increased viscosity, as seen in polycythemia, will slow the rate of blood flow through a vessel.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      27.3
      Seconds
  • Question 26 - Which of the following movements does the iliacus muscle produce? ...

    Incorrect

    • Which of the following movements does the iliacus muscle produce?

      Your Answer: Extension of the trunk

      Correct Answer: Flexion of the thigh at the hip joint

      Explanation:

      The iliacus flexes the thigh at the hip joint when the trunk is stabilised. It flexes the trunk against gravity when the body is supine.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      18.6
      Seconds
  • Question 27 - In relation to ketamine, which of the following statements is TRUE: ...

    Correct

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

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

      Explanation:

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

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      19.4
      Seconds
  • Question 28 - Which of these is NOT a naturally occurring anticoagulant: ...

    Correct

    • Which of these is NOT a naturally occurring anticoagulant:

      Your Answer: Factor V Leiden

      Explanation:

      It’s crucial that thrombin’s impact is restricted to the injured site. Tissue factor pathway inhibitor (TFPI), which is produced by endothelial cells and found in plasma and platelets, is the first inhibitor to function. It accumulates near the site of harm induced by local platelet activation. Xa and VIIa, as well as tissue factor, are inhibited by TFPI. Other circulating inhibitors, the most potent of which is antithrombin, can also inactivate thrombin and other protease factors directly. Coagulation cofactors V and VIII are inhibited by protein C and protein S. Tissue plasminogen activator (TPA) from endothelial cells facilitates fibrinolysis by promoting the conversion of plasminogen to plasmin.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      12
      Seconds
  • Question 29 - The risk of renal impairment in a patient on ACE inhibitor therapy is...

    Correct

    • The risk of renal impairment in a patient on ACE inhibitor therapy is increased by concomitant treatment with which of the following drug classes:

      Your Answer: NSAIDs

      Explanation:

      Concomitant treatment with NSAIDs increases the risk of renal damage, and with potassium-sparing diuretics (or potassium-containing salt substitutes) increases the risk of hyperkalaemia. Hyperkalaemia and other side effects of ACE inhibitors are more common in the elderly and in those with impaired renal function and the dose may need to be reduced.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      16.6
      Seconds
  • Question 30 - In inserting a nasogastric tube, which area is least likely to be a...

    Incorrect

    • In inserting a nasogastric tube, which area is least likely to be a site of resistance when the tube goes from the nose to the stomach?

      Your Answer: At the oesophageal hiatus in the diaphragm

      Correct Answer: In the posterior mediastinum where the oesophagus is crossed by the pulmonary trunk

      Explanation:

      In the posterior mediastinum where the oesophagus is crossed by the pulmonary trunk offers the least resistance when nasogastric tube is inserted from the nose to the stomach.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      37.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Physiology (4/10) 40%
Respiratory (1/1) 100%
Anatomy (3/7) 43%
Central Nervous System (1/2) 50%
Gastrointestinal (1/2) 50%
Pharmacology (5/8) 63%
Abdomen (0/2) 0%
Cranial Nerve Lesions (1/1) 100%
Infections (1/1) 100%
Haematology (0/3) 0%
Pathology (1/4) 25%
Renal Physiology (0/1) 0%
Gastrointestinal Pharmacology (1/1) 100%
Evidence Based Medicine (0/1) 0%
Head And Neck (2/2) 100%
Cardiovascular Pharmacology (0/1) 0%
Endocrine (0/1) 0%
Renal (0/1) 0%
Cardiovascular (1/2) 50%
Cardiovascular Physiology (0/1) 0%
CNS Pharmacology (0/1) 0%
Inflammatory Responses (1/1) 100%
Respiratory Physiology (0/1) 0%
Basic Cellular (2/2) 100%
Anaesthesia (1/1) 100%
Thorax (0/1) 0%
Passmed