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  • Question 1 - The family of a 10-year-old boy was advised to take the boy to...

    Incorrect

    • The family of a 10-year-old boy was advised to take the boy to see an oncologist, for suspected lymphoma. The boy had lymphadenopathy on presentation. His mother says that he's had a fever, night sweats and has experienced weight loss. The boy underwent a lymph node biopsy at the oncologist which suggests Burkitt's lymphoma. Which oncogene are you expecting to see after molecular testing?

      Your Answer: p53

      Correct Answer: c-MYC

      Explanation:

      Burkitt lymphoma is a germinal centre B-cell-derived cancer that was instrumental in the identification of MYC as an important human oncogene more than three decades ago. Recently, new genomics technologies have uncovered several additional oncogenic mechanisms that cooperate with MYC to create this highly aggressive cancer.

    • This question is part of the following fields:

      • Clinical Sciences
      23.1
      Seconds
  • Question 2 - Intracellular proteins tagged with mannose-6-phosphate are destined to which of the following organelles?...

    Incorrect

    • Intracellular proteins tagged with mannose-6-phosphate are destined to which of the following organelles?

      Your Answer: Rough endoplasmic reticulum

      Correct Answer: Lysosome

      Explanation:

      Lysosomal hydrolases are synthesized in the rough endoplasmic reticulum and specifically transported through the Golgi apparatus to the trans-Golgi network, from which transport vesicles bud to deliver them to the endosomal/lysosomal compartment. The explanation of how the lysosomal enzymes are accurately recognized and selected over many other proteins in the trans-Golgi network relies on them being tagged with a unique marker: the mannose-6-phosphate (M6P) group, which is added exclusively to the N-linked oligosaccharides of lysosomal soluble hydrolases, as they pass through the cis-Golgi network. Generation of the M6P recognition marker depends on a reaction involving two different enzymes: UDP-N-acetylglucosamine 1-phosphotransferase and α-N-acetylglucosamine-1-phosphodiester α-N-acetylglucosaminidase.

    • This question is part of the following fields:

      • Clinical Sciences
      25.9
      Seconds
  • Question 3 - Which one of the following immunological changes is seen in progressive HIV infection?...

    Correct

    • Which one of the following immunological changes is seen in progressive HIV infection?

      Your Answer: Increase in B2-microglobulin levels

      Explanation:

      The immunological changes in HIV include depletion in CD4+ T cell, cytokine dysregulation and immune dysfunction. The dominant immunologic feature of HIV infection is progressive depletion of the helper T cell (CD4+ T cell), which reverses the normal CD4:CD8 ratio and subsequently lead to immunodeficiency. Other imuunological changes include:
      increased B2-microglobulin
      decreased IL-2 production
      polyclonal B-cell activation
      decreased NK cell function
      reduced delayed hypersensitivity responses

    • This question is part of the following fields:

      • Clinical Sciences
      16.2
      Seconds
  • Question 4 - A 55-year-old female with a history of osteoarthritis of the knee, obesity and...

    Correct

    • A 55-year-old female with a history of osteoarthritis of the knee, obesity and depression, presents with neck and right arm pain. She claims that the pain is present for two months and is triggered by flexing her neck. Clinical examination reveals sensory loss over the middle finger and palm of the hand without any obvious muscle atrophy or weakness. Which nerve root is most probably affected?

      Your Answer: C7

      Explanation:

      The most common cause of cervical radiculopathy is degenerative disease in the cervical spine. In 80–90% of patients with cervical radiculopathy, the C5/C6 or C6/C7 motion segments are affected by degenerative disease and the nearby C6 and/or C7 nerve roots are producing the symptoms. Patients with cervical radiculopathy complain of neck pain and radiating pain in the arm sometimes combined with sensory and motor disturbances in the arm and/or hand. These symptoms are accepted as being caused by the nerve root compression. Middle finger and palm of the hand are mostly rising the suspicion for C7 nerve root and median nerve involvement.

    • This question is part of the following fields:

      • Clinical Sciences
      24.1
      Seconds
  • Question 5 - A 68-year-old male patient presents with haematemesis. Gastroscopy and biopsy reveal a carcinoma....

    Incorrect

    • A 68-year-old male patient presents with haematemesis. Gastroscopy and biopsy reveal a carcinoma. Who is the one to inform the patient of his diagnosis?

      Your Answer: The doctor who performed the gastroscopy

      Correct Answer: The consultant in-charge of his care

      Explanation:

      One of the questions the therapist poses himself while informing a patient is: whom shall I inform about the diagnosis, treatment and prognosis? If we unconditionally accepted the view that information belongs to the patient from an ethical and legal standpoint, we would automatically exclude the partner and the family. Therefore, the therapist should raise another question: what is the benefit to the patient? To answer the question and the resulting dilemma, we have to leverage the long experience of family therapy and tailor it to the cases we are dealing with. It should be taken into consideration that patient and family are a dynamic system which was balanced before the onset of the disease, but is now disrupted, entering into crisis. Therefore, the denial mechanisms and personality characteristics we have previously elaborated on, and communication among members play a crucial role in determining the information strategy and the way family should be approached. In this particular case, the most appropriate person to inform the patient is the consultant, meaning the one currently responsible for the patient’s care. The patient most probably has already developed some form of close and trustful relationship with his consultant.

    • This question is part of the following fields:

      • Clinical Sciences
      20.1
      Seconds
  • Question 6 - A 34-year-old woman is admitted to the oncologist clinic for further investigations. She...

    Incorrect

    • A 34-year-old woman is admitted to the oncologist clinic for further investigations. She has experienced fever, sometimes glandular and night sweats. Clinical examination reveals lymphadenopathy and a biopsy is performed. The biopsy reveals the presence of Reed-Sternberg cells, confirming what was suspected to be a Hodgkin's lymphoma. Which cell surface marker is associated with this condition?

      Your Answer: CD21

      Correct Answer: CD15

      Explanation:

      The CD15 antigen, also known as Lewis (hapten)X, serves as an immuno-phenotypic marker for Reed-Sternberg cells and its expression has diagnostic, but also prognostic significance in Hodgkin Lymphoma.

    • This question is part of the following fields:

      • Clinical Sciences
      25.3
      Seconds
  • Question 7 - Choose the correct statement regarding endothelin: ...

    Correct

    • Choose the correct statement regarding endothelin:

      Your Answer: Endothelin antagonists are useful in primary pulmonary hypertension

      Explanation:

      Current guidelines recommend the use of ambrisentan, Bosentan (recommendation I, level of evidence A) and macitentan (I, B) in patients with PAH and WHO functional class II and III. In WHO functional class IV, the first-line drug is Epoprostenol and the recommendation for Endothelin receptor antagonists is weaker (IIb, C).

    • This question is part of the following fields:

      • Clinical Sciences
      22.1
      Seconds
  • Question 8 - Which of following does not promote the release of endothelin? ...

    Incorrect

    • Which of following does not promote the release of endothelin?

      Your Answer: ADH

      Correct Answer: Prostacyclin

      Explanation:

      Prostacyclin (PGI2) generated by the vascular wall is a potent vasodilator, and the most potent endogenous inhibitor of platelet aggregation so far discovered. Prostacyclin inhibits platelet aggregation by increasing cyclic AMP levels. Prostacyclin is a circulating hormone continually released by the lungs into the arterial circulation. Circulating platelets are, therefore, subjected constantly to prostacyclin stimulation and it is via this mechanism that platelet aggregability in vivo is controlled.

    • This question is part of the following fields:

      • Clinical Sciences
      6.1
      Seconds
  • Question 9 - Choose the correct statement regarding relative risk: ...

    Correct

    • Choose the correct statement regarding relative risk:

      Your Answer: It is the usual outcome measure of cohort studies

      Explanation:

      Relative Risk = (Probability of event in exposed group) / (Probability of event in not exposed group). The relative risk is mistaken by some, with the odds ratio and absolute risk. Relative risk is the ratio of the probability of an event occurring with an exposure versus the probability of the event occurring without the exposure. Thus to calculate the relative risk, we must know the exposure status of all individuals (either exposed or not exposed). This implies that relative risk is only appropriate for cases where the exposure status and incidence of disease can be accurately determined such as prospective cohort studies.

    • This question is part of the following fields:

      • Clinical Sciences
      16.6
      Seconds
  • Question 10 - A new blood test developed to screen individuals for cardiac failure was performed...

    Correct

    • A new blood test developed to screen individuals for cardiac failure was performed on 500 patients. The results were positive for 40 out of 50 patients with echocardiography-established heart failure. However, the test was also positive for 20 patients with no signs of heart failure. What is the positive predictive value of the test?

      Your Answer: 0.66

      Explanation:

      Positive predictive value = TP (true positives) / [TP + FP (false positives)] = 40 / (40 + 20) = 0.66

    • This question is part of the following fields:

      • Clinical Sciences
      95.2
      Seconds
  • Question 11 - A 69-year-old woman is admitted with confusion. She's known to have a history...

    Correct

    • A 69-year-old woman is admitted with confusion. She's known to have a history of multiple myeloma. Blood exam reveals the following: Na+ = 147 mmol/l, K+ = 4.7 mmol/l, Urea = 14.2 mmol/l, Creatinine = 102 μmol/l, Adjusted calcium = 3.9 mmol/l. What is the single most appropriate management?

      Your Answer: IV 0.9% saline

      Explanation:

      NICE guidelines on hypercalcemia recommend that maintaining good hydration equals drinking 3-4 L of fluid/day, provided there are no contraindications. A low calcium diet is not necessary because intestinal absorption of calcium is reduced. The patient should avoid any other drugs or vitamins that could worsen the hypercalcemia. Mobilization is encouraged and any symptoms of hypercalcemia should be reported.

    • This question is part of the following fields:

      • Clinical Sciences
      16.5
      Seconds
  • Question 12 - A 34-year-old man presents with haemoptysis and weight loss. History reveals he suffers...

    Correct

    • A 34-year-old man presents with haemoptysis and weight loss. History reveals he suffers from night sweats and upon auscultation you notice reduced breath sounds over the apex of his right lung and significant nail clubbing. You refer him to a pneumologist who administers the following antibiotics: rifampicin, ethambutol, pyrazinamide and isoniazid. What is the mechanism of action of the first drug?

      Your Answer: Inhibit RNA synthesis

      Explanation:

      Rifampicin specifically inhibits bacterial RNA polymerase, the enzyme responsible for DNA transcription, by forming a stable drug-enzyme complex with a binding constant of 10(-9) M at 37 C.

    • This question is part of the following fields:

      • Clinical Sciences
      48
      Seconds
  • Question 13 - A 54-year-old female patient presents with a one week history of bloody diarrhoea,...

    Incorrect

    • A 54-year-old female patient presents with a one week history of bloody diarrhoea, fever and abdominal pain. She has a history of rheumatoid arthritis which she controls with methotrexate. Her stool sample shows Campylobacter jejuni. What is the single most appropriate management?

      Your Answer: Fluids + ciprofloxacin

      Correct Answer: Fluids + clarithromycin

      Explanation:

      This woman is receiving methotrexate, an immunosuppressant, to control her rheumatoid arthritis. In such immunocompromised patients, BNF suggests clarithromycin as first-line management.

    • This question is part of the following fields:

      • Clinical Sciences
      43.9
      Seconds
  • Question 14 - A study is developed to compare the calcemia of men and women with...

    Incorrect

    • A study is developed to compare the calcemia of men and women with Crohn's disease. The objective of the study is to detect any differences between the average calcium levels in men compared to women. Previous studies have shown a normal distribution regarding calcium levels. Which of the the following tests would you most likely apply?

      Your Answer: Chi-squared test

      Correct Answer: Student's unpaired t-test

      Explanation:

      A t test is a type of statistical test that is used to compare the means of two groups. It is one of the most widely used statistical hypothesis tests in pain studies. There are two types of statistical inferences: parametric and nonparametric methods. Parametric methods refer to a statistical technique in which one defines the probability distribution of probability variables and makes inferences about the parameters of the distribution. In cases in which the probability distribution cannot be defined, nonparametric methods are employed. T tests are a type of parametric method; they can be used when the samples satisfy the conditions of normality, equal variance, and independence. In this case the data is parametric, comparing two independent samples from the same population.

    • This question is part of the following fields:

      • Clinical Sciences
      33.1
      Seconds
  • Question 15 - The average weight of 64 patients with type 2 diabetes mellitus was 81...

    Incorrect

    • The average weight of 64 patients with type 2 diabetes mellitus was 81 kg, with a standard deviation of 12 kg. What is the standard error of the mean?

      Your Answer: Square root (81 / 12)

      Correct Answer: 1.5

      Explanation:

      The SEM is dependent on the variation in the population and the number of the extracted samples. A large variation in the population causes a large difference in the sample means, ultimately resulting in a larger SEM. However, as more samples are extracted from the population, the sample means move closer to the population mean, which results in a smaller SEM. In short, the SEM is an indicator of how close the sample mean is to the population mean. Standard error of the mean = standard deviation / square root (number of patients)
      The standard error of the mean is calculated by the standard deviation / square root (number of patients)

      = 12 / square root (64) = 12 / 8 = 1.5

    • This question is part of the following fields:

      • Clinical Sciences
      27.7
      Seconds
  • Question 16 - Which of the following is not a tumour suppressor gene? ...

    Correct

    • Which of the following is not a tumour suppressor gene?

      Your Answer: myc

      Explanation:

      Myc is a family of regulator genes and proto-oncogenes that code for transcription factors.

      A tumor suppressor gene, or antioncogene, is a gene that protects a cell from one step on the path to cancer. When this gene mutates to cause a loss or reduction in its function, the cell can progress to cancer, usually in combination with other genetic changes. Tumor suppressor genes can be grouped into categories including caretaker genes, gatekeeper genes, and landscaper genes; the classification schemes are continually evolving.
      Examples include:
      Gene Associated cancers
      p53 Common to many cancers, Li-Fraumeni syndrome
      APC Colorectal cancer
      BRCA1 Breast and ovarian cancer
      BRCA2 Breast and ovarian cancer
      NF1 Neurofibromatosis
      Rb Retinoblastoma
      WT1 Wilm’s tumour

    • This question is part of the following fields:

      • Clinical Sciences
      5.1
      Seconds
  • Question 17 - A 68-year-old male patient presents with central chest pain and associated flushing. He...

    Correct

    • A 68-year-old male patient presents with central chest pain and associated flushing. He claims the pain is crushing in character. ECG reveals T wave inversion in II, III and AVF. Blood exams are as follows: Troponin T = 0.9 ng/ml. Which substance does troponin bind to?

      Your Answer: Tropomyosin

      Explanation:

      Troponin T is a 37 ku protein that binds to tropomyosin, thereby attaching the troponin complex to the thin filament.

    • This question is part of the following fields:

      • Clinical Sciences
      22.1
      Seconds
  • Question 18 - A 61-year-old female presents to the A&E with malaise and muscle twitching. Her...

    Incorrect

    • 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: Magnesium

      Correct 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.

    • This question is part of the following fields:

      • Clinical Sciences
      21.2
      Seconds
  • Question 19 - Which is the best source of vitamin D per average serving for a...

    Correct

    • Which is the best source of vitamin D per average serving for a woman with suspected Osteomalacia?

      Your Answer: Cod liver oil

      Explanation:

      Serum vitamin D levels are influenced by sun exposure and diet. Cod liver oil is an important dietary vitamin D source in high-latitude countries like Norway where there is no sun-induced vitamin D production during the winter. 14 Norwegian Health Authorities have recommended 5 ml of cod liver oil daily (400 IU of vitamin D) for more than 60 years to prevent diseases like rickets, formerly more prevalent in areas with little access to vitamin D-rich fatty fish.

    • This question is part of the following fields:

      • Clinical Sciences
      12.6
      Seconds
  • Question 20 - Which form of study design would you choose if you were trying to...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Clinical Sciences
      13.5
      Seconds
  • Question 21 - A study is developed to assess a new mandible advancement device designed to...

    Incorrect

    • 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
      24.6
      Seconds
  • Question 22 - A study is developed to assess a new anti-hypertensive drug and two groups...

    Incorrect

    • A study is developed to assess a new anti-hypertensive drug and two groups of patients are randomly chosen. The first group takes an established anti-hypertensive drug for 3 months and the second group receives the new drug, again for 3 months. To assess the efficacy of the new drug, blood pressure is measured before and after taking the drug in both groups of patients. After a period of 1 month off medication, the groups swap medication and blood pressure is measured again, finally the difference in blood pressure after receiving each drug is calculated. Which of the following significance tests would you apply to assess the results of the study?

      Your Answer: Chi-squared test

      Correct Answer: Student's paired t-test

      Explanation:

      A t test is a type of statistical test that is used to compare the means of two groups. It is one of the most widely used statistical hypothesis tests in pain studies. There are two types of statistical inferences: parametric and nonparametric methods. Parametric methods refer to a statistical technique in which one defines the probability distribution of probability variables and makes inferences about the parameters of the distribution. In cases in which the probability distribution cannot be defined, nonparametric methods are employed. T tests are a type of parametric method; they can be used when the samples satisfy the conditions of normality, equal variance, and independence. In this case the data is parametric, and they belong to the same patients, so a paired t test should be used.

    • This question is part of the following fields:

      • Clinical Sciences
      27.2
      Seconds
  • Question 23 - From which cells is somatostatin secreted? ...

    Correct

    • From which cells is somatostatin secreted?

      Your Answer: D cells in the pancreas

      Explanation:

      The somatostatin-secreting D-cells comprise ,5% of the cells of the pancreatic islets. The D-cells have a complex morphology and may, via cellular process, interact with many more islet cells than suggested by their low number. D-cells are equipped with ATP-sensitive potassium channels (KATP channels).

    • This question is part of the following fields:

      • Clinical Sciences
      7.6
      Seconds
  • Question 24 - A 27-year-old lady presents with severe morning headaches associated with nausea. Head MRI...

    Correct

    • A 27-year-old lady presents with severe morning headaches associated with nausea. Head MRI reveals a large compressive tumour arising from the falx cerebri. The tumour is well delineated. What is the most probable diagnosis?

      Your Answer: Meningioma

      Explanation:

      Meningiomas are the most common benign tumours of the brain. Their name is derived from the fact that they arise from the dura mater which together with the pia matter and arachnoid mater form the meninges. The chances that a meningioma is benign are almost 98%. They are non-invasive and well delineated, causing sign and symptoms of brain compression.

    • This question is part of the following fields:

      • Clinical Sciences
      23.9
      Seconds
  • Question 25 - A 34-year-old male patient is admitted with hemisection of the spinal cord at...

    Incorrect

    • A 34-year-old male patient is admitted with hemisection of the spinal cord at the level T5, after being stabbed in the back. Which sign would you expect to see by assessing the patient's sensory function and muscle strength?

      Your Answer: Contralateral loss of temperature, ipsilateral loss of fine touch and vibration, contralateral spastic paresis

      Correct Answer: Contralateral loss of temperature, ipsilateral loss of fine touch and vibration, ipsilateral spastic paresis

      Explanation:

      Depending on the level of SCI, patients experience paraplegia or tetraplegia. Paraplegia is defined as the impairment of sensory or motor function in lower extremities. Patients with incomplete paraplegia generally have a good prognosis in regaining locomotor ability (,76% of patients) within a year. Complete paraplegic patients, however, experience limited recovery of lower limb function if their NLI is above T9. The spinothalamic tract is the one responsible for sensory information such as pain or temperature. However, it decussates at the same level the nerve root enters the spinal cord, meaning that the sensory loss will be contralateral. However, the dorsal column carries sensory fibres for fine touch and vibration and it decussates at the medulla which means that the sensory loss will be ipsilateral. The corticospinal tract is responsible for motor functions and it decussates at the medulla, meaning that the motor function loss will be ipsilateral.

    • This question is part of the following fields:

      • Clinical Sciences
      82.7
      Seconds
  • Question 26 - A scientist is using denaturation, annealing and elongation to amplify a desired fragment...

    Correct

    • A scientist is using denaturation, annealing and elongation to amplify a desired fragment of DNA. Which molecular technique is he using?

      Your Answer: Polymerase Chain Reaction (PCR)

      Explanation:

      PCR is a simple, yet elegant, enzymatic assay, which allows for the amplification of a specific DNA fragment from a complex pool of DNA. PCR can be performed using source DNA from a variety of tissues and organisms, including peripheral blood, skin, hair, saliva, and microbes. Only trace amounts of DNA are needed for PCR to generate enough copies to be analysed using conventional laboratory methods. For this reason, PCR is a sensitive assay. Each PCR assay requires the presence of template DNA, primers, nucleotides, and DNA polymerase. The DNA polymerase is the key enzyme that links individual nucleotides together to form the PCR product. The above mentioned components are mixed in a test tube or 96-well plate and then placed in a machine that allows repeated cycles of DNA amplification to occur in three basic steps. The machine is essentially a thermal cycler. It has a thermal block with holes, into which the test tubes or plates holding the PCR reaction mixture are inserted. The machine raises and lowers the temperature of the block in discrete, precise and pre-programmed steps. The reaction solution is first heated above the melting point of the two complementary DNA strands of the target DNA, which allows the strands to separate, a process called denaturation. The temperature is then lowered to allow the specific primers to bind to the target DNA segments, a process known as hybridization or annealing. Annealing between primers and the target DNA occurs only if they are complementary in sequence (e.g. A binding to G). The temperature is raised again, at which time the DNA polymerase is able to extend the primers by adding nucleotides to the developing DNA strand. With each repetition of these three steps, the number of copied DNA molecules doubles.

    • This question is part of the following fields:

      • Clinical Sciences
      20.7
      Seconds
  • Question 27 - A 54-year-old man is found collapsed in the street and is brought to...

    Correct

    • 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.

    • This question is part of the following fields:

      • Clinical Sciences
      17.2
      Seconds
  • Question 28 - Choose the most important stimulator of the central chemoreceptors: ...

    Incorrect

    • Choose the most important stimulator of the central chemoreceptors:

      Your Answer: Decrease in pCO2

      Correct Answer: Decrease in pH

      Explanation:

      Central chemoreception refers to the detection of changes in CO2/H+ within the brain and the associated effects on breathing. In the conscious animal the response of ventilation to changes in the brain’s interstitial fluid (ISF) pH is very sensitive. Note that a small change in cerebrospinal fluid (CSF) pH from 7.30 to 7.25 is associated with a doubling of alveolar ventilation; it is a very sensitive reflex response. Note also that the relationship of alveolar ventilation to ISF pH is essentially the same for both types of stimulation, metabolic acid-base disorders and primary CO2 stimulation.

    • This question is part of the following fields:

      • Clinical Sciences
      7.2
      Seconds
  • Question 29 - A 19-year-old lady with established anorexia nervosa is admitted with a BMI of...

    Incorrect

    • A 19-year-old lady with established anorexia nervosa is admitted with a BMI of 16. However, she gives the consent to be fed by a nasogastric tube. Which of the following electrolyte disturbances are you most likely to find?

      Your Answer: Metabolic acidosis

      Correct Answer: Hypophosphataemia

      Explanation:

      Refeeding syndrome can be defined as the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally). These shifts result from hormonal and metabolic changes and may cause serious clinical complications. The hallmark biochemical feature of refeeding syndrome is hypophosphatemia. However, the syndrome is complex and may also feature abnormal sodium and fluid balance; changes in glucose, protein, and fat metabolism; thiamine deficiency; hypokalaemia; and hypomagnesaemia.

    • This question is part of the following fields:

      • Clinical Sciences
      15.8
      Seconds
  • Question 30 - A 23-year-old man is referred to the pneumologist with a suspicion of bronchiectasis....

    Incorrect

    • A 23-year-old man is referred to the pneumologist with a suspicion of bronchiectasis. History reveals he's been having recurrent pulmonary infections his whole life together with difficulties gaining weight. He's a non-smoker with a clear family history and he admits inhalers haven't helped him in the past. He is finally suspected of having cystic fibrosis. What is the normal function of the cystic fibrosis transmembrane regulator?

      Your Answer:

      Correct Answer: Chloride channel

      Explanation:

      Chloride channels are involved in a diverse set of functions in normal physiology and acquired diseases. Additionally, there are genetic diseases caused by mutations in chloride channels (channelopathies) — the most common being cystic fibrosis, which has a prevalence of 1 in 2,000 Caucasians.

    • This question is part of the following fields:

      • Clinical Sciences
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Clinical Sciences (14/29) 48%
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