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  • Question 1 - Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is...

    Incorrect

    • Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is responsible for 20% of all leukemias.Which of the following statements about CML is NOT TRUE?

      Your Answer: There is typically a low neutrophil alkaline phosphatase score

      Correct Answer: Serum B12 is typically low

      Explanation:

      Chronic myeloid leukaemia is most common in middle-aged and elderly people. It is responsible for 20% of all leukemias. The majority of CML patients experience fatigue, weight loss, and excessive sweating.The Philadelphia chromosome is found in over 90% of CML cases. A balanced translocation between chromosomes 9 and 22 is known as the Philadelphia chromosome.Because white cells produce a B12 binding protein, serum B12 levels in CML are typically high.In CML, the neutrophil alkaline phosphatase score is usually low.Almost all patients with CML eventually progress to blast crisis, though this can take up to ten years. If any of the following features are present in a CML patient, a blast crisis is diagnosed:In the blood or bone marrow, there are more than 20% myeloblasts or lymphoblasts.On a bone marrow biopsy, large clusters of blasts were discovered.CML can be treated with tyrosine kinase inhibitors like imatinib and dasatinib if a chloroma (a solid tumour made up of myeloblasts that grows outside of the bone marrow) is present.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      41.5
      Seconds
  • Question 2 - Aside from the inability to extend the leg above the knee, which of...

    Correct

    • Aside from the inability to extend the leg above the knee, which of the following clinical symptoms should you anticipate seeing in a patient who had a pelvic and right leg injury as well as femoral nerve damage?

      Your Answer: Loss of sensation over the anterior thigh

      Explanation:

      The femoral nerve runs down the front of the leg from the pelvis. It gives the front of the thigh and a portion of the lower leg sensation. Extension of the leg at the knee joint, flexion of the thigh at the hip are produced by muscles that is primarily innervated by the femoral nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      33.1
      Seconds
  • Question 3 - By the third day of wound healing, which sort of inflammatory cell has...

    Correct

    • By the third day of wound healing, which sort of inflammatory cell has predominated:

      Your Answer: Macrophages

      Explanation:

      The inflammatory phase of healing is sometimes called the lag phase because wound strength does not begin to return immediately. The inflammatory phase is completed within three days except in the presence of infection or other factors associated with impaired wound healing. Mononuclear leukocytes accumulate and are transformed into macrophages. The maturation of blood-derived monocytes into macrophages is heralded by several events, including secretion of vimentin, which is a structural filament protein involved in wound healing.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      11.4
      Seconds
  • Question 4 - A 30-year-old male farmer presents to the Emergency Department due to a wound...

    Correct

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

      Your Answer: Tetanus vaccination and 500 IU tetanus immunoglobulin

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      24.4
      Seconds
  • Question 5 - An analytical cohort study aimed to determine a relationship between intake of dietary...

    Correct

    • An analytical cohort study aimed to determine a relationship between intake of dietary calcium and incidence of hip fractures among post-menopausal women. The following are the data obtained from the study:No. of post-menopausal women who took Calcium: 500No. of post-menopausal women who took Calcium and suffered a hip fracture: 10No. of post-menopausal women who took placebo: 500No. of post-menopausal women who took placebo and suffered a hip fracture: 25Compute for the absolute risk in the placebo group.

      Your Answer: 0.05

      Explanation:

      The absolute risk (AR) is the probability or chance of an event. It is computed as the number of events in treated or control groups, divided by the number of people in that group.AR = 25/500 = 0.05

    • This question is part of the following fields:

      • Evidence Based Medicine
      144.5
      Seconds
  • Question 6 - Fusidic acid is primarily indicated for infections caused by which of the following...

    Correct

    • Fusidic acid is primarily indicated for infections caused by which of the following microorganisms:

      Your Answer: Staphylococcal infections

      Explanation:

      Fusidic acid is a narrow spectrum antibiotic used for staphylococcal infections, primarily topically for minor staphylococcal skin (impetigo) or eye infection. It is sometimes used orally for penicillin-resistant staphylococcal infection, including osteomyelitis or endocarditis, in combination with other antibacterials.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      12.5
      Seconds
  • Question 7 - One of these statements about significance tests is true. ...

    Correct

    • One of these statements about significance tests is true.

      Your Answer: A p value of less than 1 in 20 is considered ‘statistically significant’

      Explanation:

      The p value is statistically significant when it is less than 0.05 (5% or 1 in 20).Statistical significance is not the same as clinical significance. The null hypothesis states that there is no difference between the groups.The power of a study is the probability of correctly rejecting the null hypothesis when it is false.A type I error occurs when the null hypothesis has been rejected when it is true. A type II error occurs when the null hypothesis has been accepted when it is actually false.

    • This question is part of the following fields:

      • Evidence Based Medicine
      50.1
      Seconds
  • Question 8 - A patient has an elevated potassium level of 6.7 mmol/L. All of the...

    Incorrect

    • A patient has an elevated potassium level of 6.7 mmol/L. All of the following conditions may cause elevated potassium levels, except for which one?

      Your Answer: Beta-blockers

      Correct Answer: Bartter’s syndrome

      Explanation:

      Bartter’s syndrome is an autosomal recessive renal tubular disorder characterized by hypokalaemia, hypochloraemia, metabolic alkalosis, and hyperreninemia with normal blood pressure. The underlying kidney abnormality results in excessive urinary losses of sodium, chloride, and potassium. Bartter’s syndrome does not cause an elevated potassium level, but instead causes a decrease in its concentration (hypokalaemia). The other choices are causes of hyperkalaemia or elevated potassium levels. Renal failure, Addison’s disease (adrenal insufficiency), congenital adrenal hyperplasia, renal tubular acidosis (type 4), rhabdomyolysis, burns and trauma, tumour syndrome, and acidosis are non-drug causes of hyperkalaemia. On the other hand, drugs that can cause hyperkalaemia include ACE inhibitors, angiotensin receptor blockers, NSAIDs, beta-blockers, digoxin, and suxamethonium.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      11.8
      Seconds
  • Question 9 - Antidiuretic hormone (ADH) levels are found to be increased in a young lady with...

    Correct

    • Antidiuretic hormone (ADH) levels are found to be increased in a young lady with unexplained hyponatraemia.Which of the following is a result of the release of ADH?

      Your Answer: Small volumes of concentrated urine

      Explanation:

      ADH, or antidiuretic hormone, is a hormone that regulates water and electrolyte balance. It is released in response to a variety of events, the most important of which are higher plasma osmolality or lower blood pressure. ADH increases plasma volume and blood pressure via acting on the kidneys and peripheral vasculature.ADH causes extensive vasoconstriction by acting on peripheral V1 Receptors.ADH binds to B2 Receptors in the terminal distal convoluted tubule and collecting duct of the kidney, increasing transcription and aquaporin insertion in the cells that line the lumen. Aquaporins are water channels that allow water to pass through the tubule and into the interstitial fluid via osmosis, lowering urine losses.The permeability of the distal collecting duct (the section within the inner medulla) to urea is likewise increased by ADH. More urea travels out of the tubule and into the peritubular fluid, contributing to the counter current multiplier, which improves the Loop of Henle’s concentrating power.Overall, there is enhanced urea and water reabsorption in the presence of ADH, resulting in modest amounts of concentrated urine. There is minimal urea and water reabsorption in the absence of ADH, resulting in huge amounts of dilute urine.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      22.8
      Seconds
  • Question 10 - A 17-year-old male patient diagnosed with cystic fibrosis is experiencing shortness of breath,...

    Correct

    • 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: 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
      35.3
      Seconds
  • Question 11 - A 55-year-old female is urgently rushed into the Emergency Department as she complains...

    Correct

    • A 55-year-old female is urgently rushed into the Emergency Department as she complains of chest pain that is worse on breathing, shortness of breath, palpitations, and haemoptysis. She undergoes a CT pulmonary angiogram, which reveals a large pulmonary embolus. She is immediately started on heparin and shifted to the acute medical ward.Which of the following statements is true regarding heparin?

      Your Answer: It activates antithrombin III

      Explanation:

      Heparin is a polymer of glycosaminoglycan. It occurs naturally and is found in mast cells. Clinically, it is used in two forms:1. Unfractionated: widely varying polymer chain lengths2. Low molecular weight: Smaller polymers only Heparin works by binding to and activating the enzyme inhibitor antithrombin III. Antithrombin III inactivates thrombin (factor IIa) by forming a 1:1 complex with thrombin. The heparin-antithrombin III complex also inhibits factor Xa and some other proteases involved with clotting. The heparin-ATIII complex can also inactivate IX, XI, XII, and plasmin.Heparin is not thrombolytic or fibrinolytic. It prevents the progression of existing clots by inhibiting further clotting. The lysis of existing clots relies on endogenous thrombolytics.Heparin is used for:1. Prevention and treatment of venous thromboembolism2. Treatment of disseminated intravascular coagulation3. Treatment of fat embolism4. Priming of haemodialysis and cardiopulmonary bypass machinesThere is no evidence that heparin is superior to low-molecular-weight heparins in preventing mortality from thrombosis.Vitamin K is used to reverse the effects of warfarin but not heparin. For heparin, protamine sulphate is used to counteract its effects.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      65.2
      Seconds
  • Question 12 - What is the approximate lifespan of the mature erythrocyte: ...

    Incorrect

    • What is the approximate lifespan of the mature erythrocyte:

      Your Answer: 90 days

      Correct Answer: 120 days

      Explanation:

      Erythrocytes have a normal lifespan of about 120 days. Mature erythrocytes are biconcave discs with no nucleus, ribosomes or mitochondria but with the ability to generate energy as ATP by the anaerobic glycolytic pathway. The red cell membrane consists of a bipolar lipid layer with a membrane skeleton of penetrating and integral proteins anchoring carbohydrate surface antigens. The shape and flexibility of red cells allows them to deform easily and pass through capillaries.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      12.7
      Seconds
  • Question 13 - Regarding cross-sectional studies, which of the following statements is CORRECT: ...

    Correct

    • Regarding cross-sectional studies, which of the following statements is CORRECT:

      Your Answer: They are particularly suitable for estimating point prevalence.

      Explanation:

      Cross-sectional studies aim to provide data about population health, normal ranges of biological parameters, and disease prevalence or severity by observing the entire population, or a representative subset, at a single point in time. Cross-sectional studies are relatively simple and quick to perform and can be used to study multiple outcomes, but are subject to confounding and recall bias and are not suitable for studying rare diseases. Cross-sectional studies cannot be used to assess causation or to consider trends over time.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      72
      Seconds
  • Question 14 - Regarding the flexor digitorum profundus muscle, which of the following is true? ...

    Correct

    • Regarding the flexor digitorum profundus muscle, which of the following is true?

      Your Answer: The medial aspect of the muscle is innervated by the ulnar nerve

      Explanation:

      Flexor digitorum profundus is a fusiform muscle located deep within the anterior (flexor) compartment of the forearm. Along with the flexor pollicis longus and pronator quadratus muscles, it comprises the deep flexor compartment of the forearm.Flexor digitorum profundus has a dual innervation:(1) The medial part of the muscle, that inserts to the fourth and fifth digits, is innervated by the ulnar nerve (C8-T1);(2) The lateral part, that inserts to the second and third digits, is innervated by the median nerve, via anterior interosseous branch (C8-T1).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      24.8
      Seconds
  • Question 15 - A 66-year-old female who is a known case of atrial fibrillation comes to...

    Correct

    • A 66-year-old female who is a known case of atrial fibrillation comes to the Emergency Department with the complaint of fever and vomiting for the past two days. When her medical chart is reviewed, you see that she takes Warfarin for her arrhythmia. Which ONE of the following medications cannot be prescribed to this patient?

      Your Answer: Ibuprofen

      Explanation:

      Like other non-steroidal anti-inflammatory drugs, Ibuprofen cannot be given with Warfarin as it would increase the bleeding risk of this patient.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      53.4
      Seconds
  • Question 16 - A young male has presented to you with respiratory depression and small pupils...

    Correct

    • A young male has presented to you with respiratory depression and small pupils on examination. You diagnose opioid overdose and immediately start therapy with Naloxone.Which of the following statements is TRUE regarding naloxone?

      Your Answer: It can be given by a continuous infusion if repeated doses are required

      Explanation:

      Naloxone is a short-acting, specific antagonist of mu(μ)-opioid receptors. It is used to reverse the effects of opioid toxicity. It can be given by a continuous infusion if repeated doses are required and the infusion rate is adjusted according to the vital signs. Initially, the infusion rate can be set at 60% of the initial resuscitative IV dose per hour.Naloxone has a shorter duration of action (6-24 hours) than most opioids and so close monitoring according to the respiratory rate and depth of coma and repeated injections are necessary. When repeated doses are needed in opioid addicts, naloxone administration may precipitate a withdrawal syndrome with abdominal cramps, nausea and diarrhoea, but these usually settle within 2 hours.An initial dose of 0.4 to 2 mg can be given intravenously and can be repeated at 2 to 3-minute intervals to a maximum of 10mg. If the intravenous route is inaccessible, naloxone can be administered via an IO line, subcutaneously (SQ), IM, or via the intranasal (IN) route.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      16.5
      Seconds
  • Question 17 - A 29-year-old man presents with painful red eye with copious discharge and you...

    Incorrect

    • A 29-year-old man presents with painful red eye with copious discharge and you make a diagnosis of infective conjunctivitis following a history and an examination,.One of these is NOT an indication for an urgent ophthalmology referral in this patient.

      Your Answer: Conjunctivitis associated with rheumatoid arthritis

      Correct Answer: Bilateral conjunctivitis

      Explanation:

      Urgent referral to ophthalmology is indicated if the patient with conjunctivitis has any of the following:Suspected gonococcal or chlamydial conjunctivitisCorneal involvement associated with soft contact lens useSevere disease indicated by presence of a pseudomembraneConjunctivitis associated with rheumatoid arthritis or in immunocompromised patient. Ophthalmia neonatorum.Possible herpes infection.Had recent intraocular surgery. A red flag indicating a serious cause of red eye.Suspected periorbital or orbital cellulitis.Bilateral conjunctivitis is not an indication for urgent referral to ophthalmology.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      47.1
      Seconds
  • Question 18 - Which of the following statements regarding hookworm is FALSE: ...

    Correct

    • Which of the following statements regarding hookworm is FALSE:

      Your Answer: Transmission of hookworm is via ingestion of contaminated food and water.

      Explanation:

      The hookworm life cycle begins with the passage of eggs from an adult host into the stool. Hookworm eggs hatch in the soil to release larvae that mature into infective larvae. Infection is usually transmitted by larval penetration into human skin (duodenal infection may also be transmitted by the oral route). From the skin, larvae migrate into the blood vessels and are carried to the lungs, where they penetrate the pulmonary alveoli, ascend the bronchial tree to the pharynx, and are swallowed.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      14.9
      Seconds
  • Question 19 - A patient noticed ankle swelling and has passed very little urine over the...

    Correct

    • A patient noticed ankle swelling and has passed very little urine over the past 24 hours. He also has nausea and vomiting, reduced urine output and his blood results reveal a sudden rise in his creatinine levels over the past 48 hours. You make a diagnosis of acute kidney injury (AKI).Which one of these is a prerenal cause of AKI?

      Your Answer: Cardiac failure

      Explanation:

      The causes of AKI can be divided into pre-renal, intrinsic renal and post-renal causes. Majority of AKI developing in the community is due to a pre-renal causes (90% of cases).Pre-renal causes: Haemorrhage, severe vomiting or diarrhoea, burns, cardiac failure, liver cirrhosis, nephrotic syndrome, hypotension, severe cardiac failure, NSAIDs, COX-2 inhibitors, ACE inhibitors or ARBs, Abdominal aortic aneurysm, renal artery stenosis, hepatorenal syndrome, Intrinsic (renal) causes:Eclampsia, glomerulonephritis, thrombosis, haemolytic-uraemic syndrome, acute tubular necrosis (ATN), acute interstitial nephritis, drugs ( NSAIDs), infection or autoimmune diseases, vasculitis, polyarteritis nodosa, thrombotic microangiopathy, cholesterol emboli, renal vein thrombosis, malignant hypertensionPost-renal causes: Renal stones, Blood clot, Papillary necrosis, Urethral stricture, Prostatic hypertrophy or malignancy, Bladder tumour, Radiation fibrosis, Pelvic malignancy, Retroperitoneal fibrosis

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      10.8
      Seconds
  • Question 20 - Hepatitis A is transmitted by which of the following routes: ...

    Correct

    • Hepatitis A is transmitted by which of the following routes:

      Your Answer: Faecal-oral route

      Explanation:

      Hepatitis A transmission is by the faecal-oral route; the virus is excreted in bile and shed in the faeces of infected people.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      5.2
      Seconds
  • Question 21 - Regarding tapeworm, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Humans may be infected by pork tapeworm or poultry tapeworm.

      Correct Answer: Diagnosis is by direct visualisation of characteristic eggs in the stool.

      Explanation:

      Diagnosis of tapeworm is by direct visualisation of characteristic eggs in stool. Humans may be infected by pork or beef tapeworm. Treatment is with praziquantel or niclosamide. Specialist advice should be sought for the management of neurocysticercosis.Iron-deficiency anaemia is typically seen in hookworm infection. Threadworms migrate from the intestine at night to lay eggs on the perianal skin. Mebendazole is first line treatment for threadworms.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      45.1
      Seconds
  • Question 22 - A 68-year-old man with BPH presents to the emergency department in significant pain...

    Correct

    • A 68-year-old man with BPH presents to the emergency department in significant pain secondary to urinary retention. What is the location of the neuronal cell bodies that are responsible for urinary bladder discomfort sensation?

      Your Answer: Dorsal root ganglia of spinal cord levels S2, S3 and S4

      Explanation:

      The activation of stretch receptors with visceral afferents relayed through the pelvic nerve plexus and into the pelvic splanchnic nerves causes bladder pain. The sensory fibres of spinal nerves S2 – S4 enter the dorsal root ganglia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      20.4
      Seconds
  • Question 23 - You received a patient with a 2-day history of diarrhoea and vomiting. Later,...

    Correct

    • You received a patient with a 2-day history of diarrhoea and vomiting. Later, after examination, the patient was found to have progressive symmetric descending flaccid paralysis, initial development of blurred vision, dysphagia, and weakness of the upper limbs. The patient is apyrexial and his observations are all normal. Which of the following pathogens is responsible for the said symptoms?

      Your Answer: Clostridium botulinum

      Explanation:

      A botulism infection results in neuroparalysis caused by the neurotoxin generated by Clostridium botulinum. Food-borne botulism symptoms often appear 12-36 hours after ingestion of the toxin-containing food and may include nausea, vomiting, stomach discomfort, and diarrhoea at first. The most common neurological pattern is an acute onset of bilateral cranial neuropathies with symmetric declining weakening. Other distinguishing characteristics include the absence of fever, the absence of cognitive abnormalities, the presence of a normal heart rate and blood pressure, and the absence of sensory defects.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      48.3
      Seconds
  • Question 24 - Which of the following clinical features would you least expect to see in...

    Incorrect

    • Which of the following clinical features would you least expect to see in a lesion of the frontal lobe:

      Your Answer: Inability to problem solve

      Correct Answer: Contralateral homonymous hemianopia with macular sparing

      Explanation:

      Contralateral homonymous hemianopia with macular sparing results from damage to the primary visual cortex of the occipital lobe. Incontinence may occur due to damage of the cortical micturition centre in the prefrontal cortex. Primitive reflexes and inability to problem solve may occur due to damage to the prefrontal cortex. Motor weakness of the contralateral limb with UMN signs may occur due to damage of the primary motor cortex.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      24.3
      Seconds
  • Question 25 - Which of the following is NOT a typical feature of lithium toxicity: ...

    Correct

    • Which of the following is NOT a typical feature of lithium toxicity:

      Your Answer: Miosis

      Explanation:

      Features of toxicity include:Increasing gastrointestinal disturbances (vomiting, diarrhoea, anorexia)Visual disturbancesPolyuria and incontinenceMuscle weakness and tremorTinnitusCNS disturbances (dizziness, confusion and drowsiness increasing to lack of coordination, restlessness, stupor)Abnormal reflexes and myoclonusHypernatraemiaWith severe overdosage (serum-lithium concentration > 2 mmol/L) seizures, cardiac arrhythmias (including sinoatrial block, bradycardia and first-degree heart block), blood pressure changes, electrolyte imbalance, circulatory failure, renal failure, coma and sudden death may occur.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      12.8
      Seconds
  • Question 26 - Regarding fat digestion, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding fat digestion, which of the following statements is CORRECT:

      Your Answer: Chylomicrons are exocytosed from enterocytes to enter nutrient capillaries.

      Correct Answer: Lipids are reesterified in the smooth endoplasmic reticulum of the enterocyte.

      Explanation:

      Fats are digested almost entirely in the small intestine and are only released from the stomach into the duodenum at the rate at which they can be digested (the presence of fatty acids and monoglycerides in the duodenum inhibits gastric emptying). In the duodenum fat is emulsified by bile acids, a process where larger lipid droplets are broken down into much smaller droplets providing a greater surface area for enzymatic digestion. Pancreatic lipase digests triglyceride into monoglycerides and free fatty acids. The products of fat digestion (fatty acids and monoglycerides), cholesterol and fat-soluble vitamins diffuse passively into the enterocytes. Once inside the epithelial cell, lipid is taken into the smooth endoplasmic reticulum where much of it is re esterified. Dietary and synthesised lipids are then incorporated into chylomicrons in the Golgi body, which are exocytosed from the basolateral membrane to enter lacteals.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      68.2
      Seconds
  • Question 27 - Regarding gentamicin, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding gentamicin, which of the following statements is INCORRECT:

      Your Answer: Gentamicin is indicated for treatment of infective endocarditis.

      Correct Answer: Gentamicin typically causes acute glomerulonephritis in toxicity.

      Explanation:

      Gentamicin is the aminoglycoside of choice in the UK and is used widely for the treatment of serious infections. It has a broad spectrum but is inactive against anaerobes and has poor activity against haemolytic streptococci and pneumococci. When used for the blind therapy of undiagnosed serious infections it is usually given in conjunction with a penicillin or metronidazole (or both). The main toxic effects are nephrotoxicity and ototoxicity due to damage to the vestibulocochlear nerve (CN VIII).Gentamicin is contraindicated in myasthenia gravis and should be used with caution in renal disease which may result in accumulation and a greater risk of toxic side effects.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      65
      Seconds
  • Question 28 - Which of the following clinical features is most suggestive of a lesion of...

    Correct

    • Which of the following clinical features is most suggestive of a lesion of the occipital lobe:

      Your Answer: Homonymous hemianopia

      Explanation:

      Homonymous hemianopia is a visual field defect involving either the two right or the two left halves of the visual fields of both eyes. It is caused by lesions of the retrochiasmal visual pathways, ie, lesions of the optic tract, the lateral geniculate nucleus, the optic radiations, and the cerebral visual (occipital) cortex

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      19.2
      Seconds
  • Question 29 - A 55-year-old woman with history of gastritis and reflux esophagitis tested positive for...

    Correct

    • A 55-year-old woman with history of gastritis and reflux esophagitis tested positive for Helicobacter pylori infection. Which of the following statements regarding Helicobacter pylori is considered true?

      Your Answer: It is helix shaped

      Explanation:

      Helicobacter pylori is a curved or helix-shaped, non-spore forming, Gram-negative, microaerophilic bacteria. It is motile, having multiple flagella at one pole. It has a lipopolysaccharide component in its outer membrane.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      16.4
      Seconds
  • Question 30 - A 19-year-old student that has presented with a headache and a petechial rash...

    Incorrect

    • A 19-year-old student that has presented with a headache and a petechial rash is diagnosed with meningitis caused by Neisseria meningitidis.Which SINGLE statement regarding Neisseria meningitidis is true?

      Your Answer: It is a Gram-negative rod

      Correct Answer: Lipo-oligosaccharide activates complement activation and cytokine release

      Explanation:

      Neisseria meningitidisis is a Gram-negative diplococcusc that can cause meningococcal meningitis.Carriage of Neisseria meningitidisis very common and it exists in the normal flora in the nasopharynx in 5 – 15% of adults. Actual disease only develops in a very small percentage of individuals. Infection is most common in the winter months and epidemics tend to occur about once every 10 years.Most invasive infections are caused by serotypes A, B or C. In the UK, most cases of meningococcal septicaemia are caused byNeisseria meningitidisgroup B. The vaccination programme forNeisseria meningitidisgroup C has made this type much less common. A vaccine for group B disease has now been initiated in children.The main determinant of the pathogenicity of Neisseria meningitidisis the antiphagocytic polysaccharide capsule. Meningococci cross mucosal epithelium by endocytosis and the capsule allows survival in the bloodstream. Lipo-oligosaccharide activates complement activation and cytokine release, resulting in shock and disseminated intravascular coagulation (DIC).Theclinical featuresof meningococcal meningitis include:Non-blanching rashNeck stiffnessHeadachePhotophobiaAltered mental state (drowsiness, confusion)Focal neurological deficitsSeizuresSeptic shockThe diagnosis is usually made clinically and confirmed by culture of blood, aspirate from the rash and CSF. Rapid antigen detection or nucleic acid amplification testing (NAAT) on blood and CSF are both sensitive and reliable.Due to the potentially life-threatening nature of the disease treatment should not wait for laboratory confirmation and antibiotics should be started immediately. In the hospital setting IV ceftriaxone (2 g adult; 80 mg/kg child) or IV cefotaxime (2 g adult; 80 mg/kg child) are the preferred agents. IM benzylpenicillin can be given as an alternative in the pre-hospital setting and chloramphenicol is a suitable alternative if there is a history of anaphylaxis to cephalosporins. Treatment does not eradicate carriage and the patient should be given ‘prophylaxis’ following recovery.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      48.4
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