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  • Question 1 - Which of the following data types does a pain-scoring system represent? ...

    Incorrect

    • Which of the following data types does a pain-scoring system represent?

      Your Answer: Discrete

      Correct Answer: Ordinal

      Explanation:

      Pain scoring systems are processes for assessing pain and the severity of illnesses that have been scientifically designed and tested. An example of ordinal categorical data is a pain scoring system.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      8.8
      Seconds
  • Question 2 - Gastrin release from antral G-cells is inhibited by all but which one of...

    Correct

    • Gastrin release from antral G-cells is inhibited by all but which one of the following:

      Your Answer: Vagal stimulation

      Explanation:

      Gastrin secretion is inhibited by:Low gastric pH (negative feedback mechanism)SomatostatinSecretinGastric inhibitory polypeptide (GIP)Cholecystokinin

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      15.1
      Seconds
  • Question 3 - A study investigating the risk of suffering a stroke in patients with atrial...

    Incorrect

    • A study investigating the risk of suffering a stroke in patients with atrial fibrillation taking the new antiplatelet drug ticagrelor, compared with standard treatment with warfarin is done over a 2-year time period. 30 of the 300 patients taking ticagrelor and 20 of the 500 patients taking warfarin suffered a stroke over the 2-year period. One of these statements is true regarding the outcomes of this study.

      Your Answer: The absolute risk reduction is 0.06

      Correct Answer: Ticagrelor increases the risk of stroke

      Explanation:

      Absolute risk and relative risk are used to assess the strength of a relationship between a disease and a factor that may affect it.Absolute risk (AR) is the risk of developing a disease over a time period:AR = the number of events that occur in a group / number of people in that groupThe absolute risk reduction (ARR) is the difference between the absolute risk in the control group (ARC) and the absolute risk in the treated group (ART). ARR = ARC – ARTThe control group is the warfarin group, therefore the ARC is 20/500 (0.04). Treatment group is the ticagrelor group and ART = 30/300 (0.1). ARR = 0.04 – 0.1 = -0.06. This shows that treatment with ticagrelor increases risk of developing stroke. This is also termed a relative risk increase.Relative risk, or risk ratio, (RR) is used to compare the risk in the two different groups. It is the ratio of the absolute risks of the disease in the treatment group (ART) to the absolute risk of the disease in the control group (ARC):RR=ART /ARCTherefore RR = 0.1 / 0.04 = 2.5RR < 1 means the intervention reduces the risk of the outcome being studiedRR = 1 means the treatment has no effect on the outcome being studiedRR > 1 means the intervention increased the risk of the outcome being studiedSince RR is 2.5, ticagrelor increases the risk of stroke.SUMMARYAbsolute risk reduction is -0.06Absolute risk in warfarin group = 0.04Relative risk = 2.5Ticagrelor has no effect on stroke is incorrect because RR is not =1

    • This question is part of the following fields:

      • Evidence Based Medicine
      104.3
      Seconds
  • Question 4 - Which of the following clinical features is NOT a typical feature of haemolytic...

    Correct

    • Which of the following clinical features is NOT a typical feature of haemolytic anaemias:

      Your Answer: Angular cheilitis

      Explanation:

      Features 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
      13
      Seconds
  • Question 5 - Which of the following is typically a cause of a normal anion gap metabolic...

    Correct

    • Which of the following is typically a cause of a normal anion gap metabolic acidosis:

      Your Answer: Diarrhoea

      Explanation:

      FUSEDCARS can be used to remember some of the causes of a normal anion gap acidosis:Fistula (pancreaticoduodenal)Ureteroenteric conduitSaline administrationEndocrine (hyperparathyroidism)DiarrhoeaCarbonic anhydrase inhibitors (e.g. acetazolamide)Ammonium chlorideRenal tubular acidosisSpironolactone

    • This question is part of the following fields:

      • Physiology
      • Renal
      205.4
      Seconds
  • Question 6 - Regarding acute idiopathic thrombocytopaenic purpura (ITP), which of the following statements is CORRECT:...

    Correct

    • Regarding acute idiopathic thrombocytopaenic purpura (ITP), which of the following statements is CORRECT:

      Your Answer: Over 80% of children recover without treatment.

      Explanation:

      Acute ITP is most common in children. In approximately 75% of cases, the episode follows vaccination or infection such as chicken pox or glandular fever. Most cases are caused by non-specific immune complex attachment to platelets. Acute ITP usually has a very sudden onset and the symptoms usually disappear in less than 6 months (often within a few weeks). It is usually a self-limiting condition and over 80% of children recover without treatment; in 5 – 10% of cases a chronic form of the disease develops.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      52.5
      Seconds
  • Question 7 - A suspicious growth on the posterior tongue of a 40-year-old man was discovered...

    Correct

    • A suspicious growth on the posterior tongue of a 40-year-old man was discovered by his dentist and was immediately referred for possible oral cancer. The lymph from the posterior tongue will drain to which of the following nodes?

      Your Answer: Deep cervical nodes

      Explanation:

      Lymph from the medial anterior two thirds of the tongue travels to the deep cervical lymph nodes.Lymph from the lateral anterior tongue goes to the submandibular nodes.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      18.4
      Seconds
  • Question 8 - A 62-year-old woman is brought to the Emergency Department as she is acutely...

    Correct

    • A 62-year-old woman is brought to the Emergency Department as she is acutely unwell. Her attendants inform you that she was recently started on lithium as a mood stabilizer. You instantly send a blood sample to check for lithium levels. What is the usual therapeutic range for lithium?

      Your Answer: 0.4-0.8 mmol/l

      Explanation:

      Lithium is the drug of choice for recurrent bipolar illness but should be carefully monitored as it has a very low therapeutic index. The normal therapeutic range is 0.4-0.8 mmol/l. The lower end of the range is usually the target for the elderly and as maintenance therapy. Toxicity is usually seen at levels >1.5 mmol/l. Samples should be taken 12 hours after the dose, and levels should be checked one week after starting therapy and one week after every change in dosage.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      14
      Seconds
  • Question 9 - Which of the following nerves supplies innervation to the extensor hallucis longus? ...

    Correct

    • Which of the following nerves supplies innervation to the extensor hallucis longus?

      Your Answer: Deep peroneal nerve

      Explanation:

      Extensor hallucis longus is innervated by the deep fibular nerve (root value L5 and S1).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.1
      Seconds
  • Question 10 - A 53-year-old man arrives at the emergency department complaining of visual impairment in...

    Correct

    • A 53-year-old man arrives at the emergency department complaining of visual impairment in his right eye. On examination, you notice that neither his right nor left pupil constricts when you shine a light in his right eye. When you flash a light in his left eye, the pupils of both his left and right eyes constrict. Which of the following nerves is the most likely to be affected:

      Your Answer: Optic nerve

      Explanation:

      In full optic nerve palsy, the afferent pupillary light reflex is lost. Because the afferent optic nerve does not sense light flashed in the afflicted eye, the ipsilateral direct and contralateral consensual reflexes are gone. However, the contralateral direct and ipsilateral consensual reflexes are intact because the efferent oculomotor nerve is normal.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      24.5
      Seconds
  • Question 11 - A 79-year-old male had a humeral shaft fracture during a road traffic accident...

    Correct

    • A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.All the following are responsible for this non-union EXCEPT?

      Your Answer: Osteoporosis

      Explanation:

      An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected. Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      36.3
      Seconds
  • Question 12 - A patient suffers a stab wound to the neck. The entry point of...

    Correct

    • A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck.Which of the following muscles is LEAST likely to be involved? Select ONE answer only.

      Your Answer: Sternohyoid

      Explanation:

      The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains:Muscles: thyrohyoid, sternothyroid, sternohyoid musclesOrgans: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid glandArteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteriesVeins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veinsNerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerveThe posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle.Contents:Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodesNerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexus

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      28.5
      Seconds
  • Question 13 - Glucagon is the main catabolic hormone of the body and raises the concentration...

    Correct

    • Glucagon is the main catabolic hormone of the body and raises the concentration of glucose and fat in the bloodstream.Which pancreatic islet cells secretes glucagon?

      Your Answer: Alpha

      Explanation:

      Glucagon, secreted from the pancreatic islet alpha cells, is considered to be the main catabolic hormone of the body. It raises the concentration of glucose and fat in the bloodstreamThere are five different pancreatic islet cells:Alpha cells (20%) – produce glucagonBeta cells (70%) – produce insulin and amylinDelta cells (<10%) – produce somatostatinGamma cells (<5%) – produce pancreatic polypeptideEpsilon cells (<1%) – produce ghrelin

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      11.2
      Seconds
  • Question 14 - A 70-year-old man has severe diarrhoea one week after taking co-amoxiclav for a...

    Correct

    • A 70-year-old man has severe diarrhoea one week after taking co-amoxiclav for a chest infection. The diarrhoea is yellow in colour and smell is offensive.What is the SINGLE MOST likely causative organism?

      Your Answer: Clostridium difficile

      Explanation:

      Clostridium difficile, a Gram-positive, anaerobic, spore forming bacteria is present in the gut of approximately 3% of healthy adults (2012 UK HPA estimates). Following use of broad spectrum antibiotics, which alter normal gut flora, Clostridium difficile associated diarrhoea (CDAD) occurs.About 80% of Clostridium difficile infections are seen in people over the age of 65 and its main clinical features are:Abdominal cramps, severe bloody and/or watery diarrhoea, offensive smelling diarrhoea, and fever.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      8.4
      Seconds
  • Question 15 - Most of the lymph from vessels that drain the breast is collected in...

    Correct

    • Most of the lymph from vessels that drain the breast is collected in which of the following lymph nodes?

      Your Answer: Axillary nodes

      Explanation:

      Lymph is the fluid that flows through the lymphatic system. Axillary lymph nodes are near the breasts. They are often the first location to which breast cancer spreads if it moves beyond the breast tissue. They receive approximately 75% of lymph drainage from the breast via lymphatic vessels, laterally and superiorly. The lymph usually first drains to the anterior axillary nodes, and from here, through the central axillary, apical, and supraclavicular nodes in sequence.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      6.9
      Seconds
  • Question 16 - Which of the following drugs decreases plasma-theophylline levels: ...

    Correct

    • Which of the following drugs decreases plasma-theophylline levels:

      Your Answer: Carbamazepine

      Explanation:

      Examples of enzyme-inhibiting drugs (raise plasma theophylline level):ErythromycinClarithromycinCiprofloxacinFluconazoleVerapamilAllopurinolCimetidineExamples of enzyme-inducing drugs (lower plasma theophylline level):PrimidonePhenobarbitalCarbamazepinePhenytoinRitonavirRifampicinSt John’s Wort

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      14.1
      Seconds
  • Question 17 - Which of the following is NOT a typical electrolyte disturbance caused by furosemide:...

    Correct

    • Which of the following is NOT a typical electrolyte disturbance caused by furosemide:

      Your Answer: Hypercalcaemia

      Explanation:

      Adverse effects of loop diuretics include:Mild gastrointestinal disturbances, pancreatitis and hepatic encephalopathyHyperglycaemiaAcute urinary retentionWater and electrolyte imbalanceHyponatraemia, hypocalcaemia, hypokalaemia, hypomagnesaemia, hypochloraemiaHypotension, hypovolaemia, dehydration, and venous thromboembolismMetabolic alkalosisHyperuricaemiaBlood disorders (bone marrow suppression, thrombocytopenia, and leucopenia)Visual disturbance, tinnitus and deafnessHypersensitivity reactions

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      27.6
      Seconds
  • Question 18 - A 29-year-old volunteer returns from a recent trip to the middle east with...

    Correct

    • A 29-year-old volunteer returns from a recent trip to the middle east with profuse watery diarrhoea. You make a diagnosis of cholera and organize a hospital admission for rehydration with intravenous fluids.What is the mechanism of action of cholera toxin?

      Your Answer: ADP-ribosylation of the G regulatory protein

      Explanation:

      Cholera is caused by Vibrio cholerae, a motile, Gram-negative, curved bacillus. It is transmitted through water and food (especially seafood) and is primarily a disease seen in developing countries where there is poor sanitation and lack of safe water supplies.The cholera toxin leads to stimulation of adenyl cyclase, ADP-ribosylation of the G regulatory protein, inactivation of GTPase leading to active outpouring of NaCl. The cholera toxin consists of an A (the toxin) and B subunit. The B subunit attaches to the gut mucosa and presents the A subunit to the cell. The toxin stimulates adenyl cyclase by irreversible ADP-ribosylation of the GTP binding domain of adenyl cyclase leading to the opening of chloride channels resulting in an outpouring of NaCl and water into the lumen of the gut and causing secretory diarrhoea.Incubation period is between 2 and 5 days, but can be as short as just a few hours.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      16.7
      Seconds
  • Question 19 - A 42-year-old male patient, presenting with polyuria and polydipsia symptoms had normal blood...

    Correct

    • A 42-year-old male patient, presenting with polyuria and polydipsia symptoms had normal blood test results. Upon interview, he had mentioned being in a car accident in which he had a head injury. His polyuria and polydipsia symptoms are most likely associated with which of the following conditions?

      Your Answer: Cranial diabetes insipidus

      Explanation:

      Polydipsia is the feeling of extreme thirstiness. It is often linked to polyuria, which is a urinary condition that causes a person to urinate excessively. The cycle of these two processes makes the body feel a constant need to replace the fluids lost in urination. In healthy adults, a 3 liter urinary output per day is considered normal. A person with polyuria can urinate up to 15 liters of urine per day. Both of these conditions are classic signs of diabetes. The other options are also types of diabetes, except for psychogenic polydipsia (PPD), which is the excessive volitional water intake seen in patients with severe mental illness or developmental disability. However, given the patient’s previous head injury, the most likely diagnosis is cranial diabetes insipidus. By definition, cranial diabetes insipidus is caused by damage to the hypothalamus or pituitary gland after an infection, operation, brain tumor, or head injury. And the patient’s history confirms this diagnosis. To define the other choices, nephrogenic diabetes insipidus happens when the structures in the kidneys are damaged and results in an inability to properly respond to antidiuretic hormone. Kidney damage can be caused by an inherited (genetic) disorder or a chronic kidney disorder. As with cranial diabetes insipidus, nephrogenic diabetes insipidus can also cause an elevated urine output. Diabetes mellitus is classified into two types, and the main difference between them is that type 1 diabetes is a genetic disorder, and type 2 diabetes is diet-related and develops over time. Type 1 diabetes is also known as insulin-dependent diabetes, in which the pancreas produces little or no insulin. Type 2 diabetes is termed insulin resistance, as cells don’t respond customarily to insulin.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      19.3
      Seconds
  • Question 20 - Which extraocular muscle is entrapped in a patient with a blowout fracture? ...

    Correct

    • Which extraocular muscle is entrapped in a patient with a blowout fracture?

      Your Answer: Inferior rectus

      Explanation:

      A blowout fracture is an isolated fracture of the orbital walls without compromise of the orbital rims. The common mechanisms are falls, high-velocity ball-related sports, traffic accidents, and interpersonal violence.The frontal, ethmoidal, sphenoid, zygomatic, and lacrimal bones form the bony structures of the orbit. Medially, the maxillary and the lacrimal bone form the lacrimal fossa. Together with the lamina papyracea of the ethmoid bone, they form the medial wall. The sphenoid bone forms the posterior wall and houses the orbital canal. Lateral to the orbital canal lies the superior orbital fissure housing cranial nerves III, IV, V, and VI. The zygomatic bone forms the lateral wall. Superior and inferior borders are the frontal and maxillary bones. Located around the globe of the eye and attached to it are 6 extraocular muscles; the 4 rectus muscles and the superior and inferior oblique muscles. The fat and connective tissue around the globe help to reduce the pressure exerted by the extraocular muscles.The goal of treatment is to restore aesthetics and physiological function. The problem with orbital blowout fractures is that the volume of the orbit can be increased, resulting in enophthalmos and hypoglobus. In addition, the orbital tissue and inferior rectus muscle can become trapped by the bony fragments leading to diplopia, limitation of gaze, and tethering. Finally, the orbital injury can lead to retinal oedema, hyphema, and significant loss of vision.While some cases may be managed with conservative care, others may require some type of surgical intervention.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      10.4
      Seconds
  • Question 21 - Following an injury sustained during a rugby match, a 16-year-old boy is brought...

    Incorrect

    • Following an injury sustained during a rugby match, a 16-year-old boy is brought to the Emergency Department by his mother. His forearm appears to be deformed, and you believe he has a distal radius fracture. A numerical rating scale is used to assess his pain, and the triage nurse informs you that he is in moderate pain.'The RCEM guidance recommends which of the following analgesics for the treatment of moderate pain in a child of this age?

      Your Answer: Oral paracetamol 10 mg/kg

      Correct Answer: Oral codeine phosphate 1 mg/kg

      Explanation:

      According to a 2018 audit conducted by the Royal College of Emergency Medicine (RCEM), the standard of care for children presenting to EDs with fractured limbs has deteriorated, with most patients waiting longer than ever before for pain relief. More than one-tenth of the children who came in with significant pain from a limb fracture received no pain relief at all.For all patients, including children, the Agency for Health Care Policy and Research (AHCPR) in the United States recommends using the ABCs of pain management:A – Ask about pain regularly. Assess pain systematically.B – Believe the patient and family in their reports of pain and what relieves it.C – Choose pain control options appropriate for the patient, family, and setting.D – Deliver interventions in a timely, logical, coordinated fashion.E – Empower patients and their families. Enable patients to control their course to the greatest extent possible.The RCEM guidelines recommend assessing a child’s pain within 15 minutes of arrival. This is a fundamental requirement. For the assessment of pain in children, a variety of rating scales are available; which one is used depends on the child’s age and ability to use the scale. These are some of them:Faces of Wong-Baker Scale for assessing painScale of numerical evaluationThe behavioural scale is a scale that measures how people behave.The RCEM has provided the following visual guide:The RCEM has established the following guidelines for when patients in severe pain should receive appropriate analgesia:100% within 60 minutes of arrival or triage, whichever is earliest75% within 30 minutes of arrival or triage, whichever is earliest50% within 20 minutes of arrival or triage, whichever is earliest

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      75.1
      Seconds
  • Question 22 - A diagnosis of acute osteomyelitis was made on a patient with a known...

    Correct

    • A diagnosis of acute osteomyelitis was made on a patient with a known history of sickle cell disease. He has no joint prosthesis on in-dwelling metal work and no known drug allergies.Which of the following is most likely the causative agent of the case presented above?

      Your Answer: Salmonella spp .

      Explanation:

      Patients with sickle cell disease are prone to infection of the bone and bone marrow in areas of infarction and necrosis. Although Staphylococcus aureus is the most common cause of osteomyelitis in the general population, studies have shown that in patients with sickle cell disease, the relative incidence of Salmonella osteomyelitis is twice that of staphylococcal infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      13.5
      Seconds
  • Question 23 - Which of the following statements is incorrect regarding the electron transfer system? ...

    Correct

    • Which of the following statements is incorrect regarding the electron transfer system?

      Your Answer: The electron transfer system occurs in anaerobic respiration.

      Explanation:

      The electron transfer system is responsible for most of the energy produced during respiration. The is a system of hydrogen carriers located in the inner mitochondrial membrane. Hydrogen is transferred to the electron transfer system via the NADH2molecules produced during glycolysis and the Krebs cycle. As a result, a H+ion gradient is generated across the inner membrane which drives ATP synthase. The final hydrogen acceptor is oxygen and the H+ions and O2 combine to form water.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      13.8
      Seconds
  • Question 24 - If a patient dislocated his right shoulder and has been referred to the...

    Correct

    • If a patient dislocated his right shoulder and has been referred to the orthopaedic outpatient department for a follow-up after a successful reduction, which of the following is the most important position for him to avoid holding his arm in until he is seen in the clinic?

      Your Answer: Arm at 90 degrees to side with palm up

      Explanation:

      The arm should be placed in a poly-sling that should be worn for about two weeks. A physiotherapist may give gentle movements for the arm to help in reducing stiffness and in relieving the pain. It is important that the patient must avoid positions that could cause re-dislocation.The most important position to avoid is the arm being held out at 90 degrees to the side with the palm facing upwards, especially if a force is being applied.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      37.6
      Seconds
  • Question 25 - You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble...

    Correct

    • You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble breathing after eating peanuts. Which of the following diagnostic tests will confirm this?

      Your Answer: Mast cell tryptase

      Explanation:

      The concentration of serum tryptase rises in anaphylaxis and anaphylactoid responses. Because tryptase is a significant component of mast cell granules, mast cell degranulation causes elevated tryptase levels in the blood. Although tryptase levels are not always high during anaphylaxis, it is considered a particular marker.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      8.5
      Seconds
  • Question 26 - A 23-year-old male is referred to your haematology clinic after an acute attack...

    Incorrect

    • A 23-year-old male is referred to your haematology clinic after an acute attack of haemolytic anaemia. He was diagnosed with glucose-6-phosphate dehydrogenase deficiency ten years ago. Which ONE of the following options is FALSE with regards to this disorder?

      Your Answer: It shows X-linked recessive inheritance

      Correct Answer: Acute haemolysis can be triggered by cephalosporin antibiotics

      Explanation:

      Glucose-6-phosphate dehydrogenase deficiency is an X-linked recessive disorder in which there is a deficiency of the enzyme G6PD. This causes instability of red blood cell membranes under oxidative stress leading to haemolysis.Triggers include: 1) Fava beans2) Sulphonamides3) Primaquine4) Anti-TB drugs5) Infections Most individuals will be asymptomatic until exposed to one of the triggers listed above. It is the commonest human enzyme defect and affects males more than females because of the X-linked inheritance pattern. The use of penicillins and cephalosporins is generally safe.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      81.6
      Seconds
  • Question 27 - Which of the following increases the tendency for oedema to occur? ...

    Correct

    • Which of the following increases the tendency for oedema to occur?

      Your Answer: Increased venous pressure

      Explanation:

      When more fluid is filtered out of the capillaries than can be returned to the circulation by the lymphatics, oedema occurs. Changes that increase capillary hydrostatic pressure or decrease plasma oncotic pressure will increase filtration. Arteriolar constriction reduces hydrostatic capillary pressure and transiently increase absorption of fluid. Dehydration increases plasma protein concentration and therefore increases plasma oncotic pressure and absorption. Capillary hydrostatic pressure and filtration are increased when there is increased venous pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      44.9
      Seconds
  • Question 28 - A patient presents with a history of renal problems, generalised weakness and palpitations....

    Incorrect

    • A patient presents with a history of renal problems, generalised weakness and palpitations. Her serum potassium levels are measured and come back at 6.2 mmol/L. An ECG is performed, and it shows some changes that are consistent with hyperkalaemia.Which of the following ECG changes is usually the earliest sign of hyperkalaemia? Select ONE answer only.

      Your Answer: Prolonged QRS interval

      Correct Answer: Peaked T waves

      Explanation:

      Hyperkalaemia causes a rapid reduction in resting membrane potential leading to increased cardiac depolarisation and muscle excitability. This in turn results in ECG changes which can rapidly progress to ventricular fibrillation or asystole. Very distinctive ECG changes that progressively change as the K+level increases:K+>5.5 mmol/l – peaked T waves (usually earliest sign of hyperkalaemia), repolarisation abnormalitiesK+>6.5 mmol/l – P waves widen and flatten, PR segment lengthens, P waves eventually disappearK+>7.0 mmol/l – Prolonged QRS interval and bizarre QRS morphology, conduction blocks (bundle branch blocks, fascicular blocks), sinus bradycardia or slow AF, development of a sine wave appearance (a pre-terminal rhythm)K+>9.0 mmol/l – Cardiac arrest due to asystole, VF or PEA with a bizarre, wide complex rhythm.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      18.8
      Seconds
  • Question 29 - An injury to which nerve affects innervation to the adductor portion of the...

    Correct

    • An injury to which nerve affects innervation to the adductor portion of the adductor magnus?

      Your Answer: Posterior branch of the obturator nerve

      Explanation:

      The nerves that supply the adductor magnus muscle have an embryologic origin from the anterior divisions of the lumbosacral plexus and include the obturator nerve, posterior division (L2-4), and the tibial portion of the sciatic nerve (L4). It is innervated by the posterior division of the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      20.3
      Seconds
  • Question 30 - A 22-year-old student presents with a painful, red and itchy right eye. On...

    Incorrect

    • A 22-year-old student presents with a painful, red and itchy right eye. On examination, there is mild erythema of palpebral conjunctiva, and follicles are visible on eversion of the eyelid. Lid oedema is evident, and you can also see a few petechial subconjunctival haemorrhages. The eye appears watery, and there is no purulent discharge. He has recently recovered from a mild upper respiratory tract infection.Which of these is the most likely causative organism?

      Your Answer: Streptococcus pneumoniae

      Correct Answer: Adenovirus

      Explanation:

      The most frequent cause of red eye is conjunctivitis. It is caused by inflammation of the conjunctiva which can be infective or allergic and accounts for about 35% of all eye problems presenting to general practice.Viral conjunctivitis is commonly caused by adenoviruses and it is the most common infectious conjunctivitis.The common bacterial causes of conjunctivitis are Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.The clinical features of infective conjunctivitis include:Acute onset of conjunctival erythemaFeeling ‘grittiness’, ‘foreign body’ or ‘burning’ sensation in the eye.Watering and discharge which may cause transient blurring of visionFeatures of viral conjunctivitis include: watery and non-purulent eye discharge, lid oedema, follicles present on eyelid eversion, petechial subconjunctival haemorrhages and pseudomembranes may be seen on the tarsal conjunctival surfaces.This patients features are consistent with a viral aetiology, and the most likely causative organism is adenovirus,

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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