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Question 1
Incorrect
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Which form of study design would you choose if you were trying to ascertain whether the use of dummies in infants is correlated with sudden infant death syndrome?
Your Answer: Cross-sectional survey
Correct Answer: Case-control study
Explanation:A case-control study is designed to help determine if an exposure is associated with an outcome (i.e., disease or condition of interest). In theory, the case-control study can be described simply. Case-control studies have specific advantages compared to other study designs. They are comparatively quick, inexpensive, and easy. They are particularly appropriate for (1) investigating outbreaks, and (2) studying rare diseases or outcomes. Sudden infant death syndrome is a rare medical event, thus case-control study is the most suitable option.
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This question is part of the following fields:
- Clinical Sciences
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Question 2
Incorrect
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Which one of the following statements regarding nitric oxide is incorrect?
Your Answer: In sepsis increased levels of NO contribute to septic shock
Correct Answer: Promotes platelet aggregation
Explanation:Nitric oxide, known as an endothelium-derived relaxing factor (EDRF), is biosynthesized endogenously from L-arginine, oxygen, and NADPH by various nitric oxide synthase (NOS) enzymes and is a signaling molecule in many physiological and pathological processes in humans.
One of the main enzymatic targets of nitric oxide is guanylyl cyclase. The binding of nitric oxide to the haem region of the enzyme leads to activation, in the presence of iron. -
This question is part of the following fields:
- Clinical Sciences
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Question 3
Correct
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A 54-year-old man is found collapsed in the street and is brought to the A&E. The results from the blood tests reveal Calcium = 1.62mmol/l and Albumin = 33g/l. The man is known to have a history of alcoholic liver disease. Which of the following is the best management regarding his calcium levels?
Your Answer: 10ml of 10% calcium gluconate over 10 minutes
Explanation:Acute, symptomatic hypocalcaemia is treated with 10ml of 10% calcium gluconate over 10 minutes.
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This question is part of the following fields:
- Clinical Sciences
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Question 4
Incorrect
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Choose the hormone secreted only by the adrenal medulla:
Your Answer: Aldosterone
Correct Answer: Adrenaline
Explanation:The major endocrine functions of adrenal gland are to produce catecholamines and steroids. Catecholamine, synthesized by the adrenal medulla, is responsible for blood pressure and blood flow regulation whereas steroids produced by the cortex control energy and water homeostasis and immune responses. Glucocorticoids, a major group of adrenal steroids, have a stimulatory effect on catecholamine synthesis in the medulla.
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This question is part of the following fields:
- Clinical Sciences
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Question 5
Incorrect
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Question 6
Correct
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A 61-year-old female presents to the A&E with malaise and muscle twitching. Her blood pressure is 114/78 mmHg and her pulse is 84/min. Blood exam reveals Calcium = 1.94 mmol/l and Albumin = 38 g/l. Which of the following tests is most useful in establishing her diagnosis?
Your Answer: Parathyroid hormone
Explanation:Hypocalcaemia occurs in patients with impaired function of the parathyroid glands. This is most common after thyroid or parathyroid surgery, but it can be idiopathic—mostly in young adults and less often as part of a genetic syndrome, such as autoimmune polyglandular syndrome type 1. Usually, the first and most useful test to perform in such cases is the measurement of the parathyroid hormone.
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This question is part of the following fields:
- Clinical Sciences
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Question 7
Incorrect
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Which one of the following best describes the main action of the polymerase chain reaction?
Your Answer: DNA to RNA conversion
Correct Answer: DNA amplification
Explanation:Polymerase chain reaction (PCR) is a method widely used in molecular biology to make several copies of a specific DNA segment. Using PCR, copies of DNA sequences are exponentially amplified to generate thousands to millions of more copies of that particular DNA segment.The main advantage of PCR is its sensitivity: only one strand of sample DNA is needed to detect a particular DNA sequence. It now has many uses including prenatal diagnosis, detection of mutated oncogenes and diagnosis of infections. PCR is also extensively used in forensics.
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This question is part of the following fields:
- Clinical Sciences
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Question 8
Incorrect
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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.
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This question is part of the following fields:
- Clinical Sciences
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Question 9
Incorrect
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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: Chi-squared 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
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Question 10
Incorrect
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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:
Correct 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.
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This question is part of the following fields:
- Clinical Sciences
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SESSION STATS - PERFORMANCE PER SPECIALTY
