00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - Which mechanism is not involved in the development of physiological jaundice in newborns?...

    Incorrect

    • Which mechanism is not involved in the development of physiological jaundice in newborns?

      Your Answer: Meconium facilitates enterohepatic circulation

      Correct Answer: Bilirubin present in breast milk

      Explanation:

      Physiological Jaundice in Newborns

      After birth, newborns experience increased erythrocyte turnover which requires faster action of enzymes involved in bilirubin metabolism and excretion. However, there can be a relative lack of UDP-glucuronyltransferase, leading to dysfunctional erythropoeisis and excess haem production that is metabolized to bilirubin. Meconium, which contains beta-glucuronidase, can further exacerbate the situation by changing conjugated bilirubin to an unconjugated form that is readily reabsorbed in the enterohepatic circulation.

      Breast milk does not contain bilirubin, but it does contain substances that can inhibit the conjugation reaction, slowing the metabolism of bilirubin and allowing unconjugated bilirubin levels in the blood to rise. While physiological jaundice in newborns is usually not harmful, levels of unconjugated bilirubin above 170-200 µmol/l can lead to kernicterus, which can cause seizures, brain damage, or death. To prevent this, infants are treated with phototherapy at 450 nm, which disrupts the strong hydrogen bonds holding together molecules of unconjugated bilirubin, allowing the structure to unfold and become more soluble. This facilitates its excretion and reduces serum concentrations.

    • This question is part of the following fields:

      • Clinical Sciences
      40.4
      Seconds
  • Question 2 - A 32-year old woman with asthma presents to the Emergency department with difficulty...

    Correct

    • A 32-year old woman with asthma presents to the Emergency department with difficulty breathing. Upon examination, you observe that she is utilizing accessory muscles for respiration. Can you identify which muscle is considered an accessory muscle of respiration?

      Your Answer: Serratus anterior

      Explanation:

      Accessory Muscles of Respiration

      The accessory muscles of respiration are utilized during deep inspiration and consist of several muscles. These muscles include the sternocleidomastoid, scalenus anterior, medius, and posterior, serratus anterior, and pectoralis major and minor. However, there is no consensus on the exact number of muscles that can be classified as ‘accessory’. Some lists include any muscle that can impact chest expansion. It is important to note that the trapezius muscle cannot be considered an accessory muscle of respiration as it is not connected to the ribs. Overall, the accessory muscles of respiration play a crucial role in deep breathing and chest expansion.

    • This question is part of the following fields:

      • Clinical Sciences
      20.9
      Seconds
  • Question 3 - What muscles are responsible for dorsiflexion of the ankle joint? ...

    Correct

    • What muscles are responsible for dorsiflexion of the ankle joint?

      Your Answer: Tibialis anterior

      Explanation:

      Muscles Involved in Ankle and Toe Movements

      The tibialis anterior muscle is responsible for dorsiflexion of the ankle joint, which means it helps lift the foot upwards towards the shin. On the other hand, the tibialis posterior, soleus, and gastrocnemius muscles are involved in plantar flexion, which is the movement of pointing the foot downwards. These muscles work together to push the foot off the ground during walking or running.

      Another muscle involved in foot movement is the flexor digitorum longus, which is responsible for flexion of the second to fifth toes. This muscle helps curl the toes downwards towards the sole of the foot. All of these muscles play important roles in the complex movements of the foot and ankle, allowing us to walk, run, jump, and perform other activities that require precise control of our lower limbs.

    • This question is part of the following fields:

      • Clinical Sciences
      29.1
      Seconds
  • Question 4 - A 25-year-old female has been diagnosed with iron deficiency while pregnant.

    What is the...

    Correct

    • A 25-year-old female has been diagnosed with iron deficiency while pregnant.

      What is the primary role of iron in the human body?

      Your Answer: Haemoglobin synthesis

      Explanation:

      The Importance of Iron in the Human Body

      Iron plays a crucial role in maintaining a healthy human body. One of its primary functions is to transport oxygen throughout the body via haemoglobin, a protein found in red blood cells. Additionally, iron is an essential component of cytochromes, which are necessary for the production of ATP and drug metabolism. Iron is also required for the production of myoglobin, which is necessary for normal muscle function.

      Unfortunately, iron deficiency is prevalent, especially in children, menstruating women, and pregnant patients. Vegetarians are also at a higher risk of deficiency since animal sources of iron are more easily absorbed than plant sources. To combat iron deficiency, it is recommended to consume foods rich in iron, such as liver, chicken, pulses, leafy green vegetables, and fish. By ensuring adequate iron intake, individuals can maintain optimal health and function.

    • This question is part of the following fields:

      • Clinical Sciences
      11.8
      Seconds
  • Question 5 - Which artery are you feeling when you detect an arterial pulsation on the...

    Incorrect

    • Which artery are you feeling when you detect an arterial pulsation on the mandible at the anterior border of the masseter muscle during a routine head and neck examination?

      Your Answer: The marginal mandibular artery

      Correct Answer: The facial artery

      Explanation:

      Arteries of the Face

      The face is supplied with blood by several arteries, each with its own unique path and function. The facial artery, for instance, curves around the mandible before continuing on a winding journey to reach the medial canthus of the eye. Meanwhile, the lingual artery is responsible for supplying blood to the tongue and floor of the mouth. The marginal mandibular artery, on the other hand, provides blood to the depressor labii inferioris and depressor anguli oris. The maxillary artery, which supplies the deep structures of the face including the mandible and pterygoid, is also an important contributor to facial blood flow. Finally, the superficial temporal artery is responsible for supplying the temporalis muscle and the scalp. the unique roles of each of these arteries is crucial for proper diagnosis and treatment of facial injuries and conditions.

    • This question is part of the following fields:

      • Clinical Sciences
      45.9
      Seconds
  • Question 6 - Which muscles are responsible for flexing the hip joint? ...

    Correct

    • Which muscles are responsible for flexing the hip joint?

      Your Answer: Psoas

      Explanation:

      Muscles and their Functions in Joint Movement

      The hip joint has three main flexors, namely the iliacus, psoas, and rectus femoris muscles. These muscles are responsible for flexing the hip joint, which is the movement of bringing the thigh towards the abdomen. On the other hand, the gluteus maximus and medius muscles are involved in hip extension, which is the movement of bringing the thigh backward.

      Moving on to the elbow joint, the bicep femoris muscle is one of the primary flexors. This muscle is responsible for bending the elbow, which is the movement of bringing the forearm towards the upper arm. Lastly, the adductor brevis muscle is responsible for adducting the leg at the hip joint, which is the movement of bringing the leg towards the midline of the body.

      In summary, muscles play a crucial role in joint movement. the functions of these muscles can help in identifying and addressing issues related to joint movement and mobility.

    • This question is part of the following fields:

      • Clinical Sciences
      21.8
      Seconds
  • Question 7 - What is the hormone responsible for controlling blood sodium levels? ...

    Incorrect

    • What is the hormone responsible for controlling blood sodium levels?

      Your Answer: Triiodothyronine

      Correct Answer: Antidiuretic hormone

      Explanation:

      The Role of Antidiuretic Hormone in Regulating Blood Sodium Levels

      Antidiuretic hormone (ADH) is a polypeptide hormone produced in the hypothalamus and released into the circulation by the posterior pituitary. Its main function is to promote the reabsorption of water from the kidney, preventing its loss in the urine. This, in turn, has a secondary effect on blood sodium levels.

      ADH works by stimulating the production of a water channel called aquaporin, which is inserted into the cell membrane of cells lining the collecting duct of the kidney. This allows water molecules to move from the collecting duct lumen into the cells, from where they can move back to the interstitial fluid and the bloodstream. As a result, less water is lost in the urine, and blood sodium levels are regulated.

      In summary, ADH plays a crucial role in regulating blood sodium levels by conserving water and preventing its loss in the urine. Its action on aquaporin production allows for the reabsorption of water from the kidney, which has a secondary effect on blood sodium levels.

    • This question is part of the following fields:

      • Clinical Sciences
      29.9
      Seconds
  • Question 8 - In which location do most intracerebral hemorrhages take place? ...

    Incorrect

    • In which location do most intracerebral hemorrhages take place?

      Your Answer: Hypothalamus

      Correct Answer: Basal ganglia

      Explanation:

      Types and Locations of Intracranial Bleeds

      Intracranial bleeds refer to any type of bleeding that occurs within the cranium. There are four main types of intracranial bleeds: extradural, subdural, subarachnoid, and intracerebral. Extradural bleeds occur outside the periosteal dura mater, while subdural bleeds occur between the meningeal dura mater and arachnoid mater. Subarachnoid bleeds occur between the arachnoid mater and pia mater, where cerebrospinal fluid circulates. Intracerebral bleeds, on the other hand, occur within the cerebral tissue itself.

      Of all the types of intracranial bleeds, intracerebral bleeds are the most common. They typically occur deep within the cerebral hemispheres, affecting the basal ganglia, such as the caudate nucleus and putamen. These types of bleeds are usually caused by hypertension, rather than trauma or atherosclerosis. While it is possible for bleeds to occur in any area of the brain, those that occur in the brainstem are particularly debilitating.

    • This question is part of the following fields:

      • Clinical Sciences
      14.1
      Seconds
  • Question 9 - In response to cigarette smoke, does the respiratory epithelium undergo metaplasia and if...

    Incorrect

    • In response to cigarette smoke, does the respiratory epithelium undergo metaplasia and if so, what type of epithelial cell does it form?

      Your Answer: Simple columnar

      Correct Answer: Stratified squamous

      Explanation:

      Epithelial Tissue and its Metaplasia

      Epithelial tissue is a type of tissue that lines the surfaces of organs and structures in the body. Respiratory epithelium, which is made up of pseudostratified, ciliated columnar cells, can undergo a process called metaplasia. This is when the tissue transforms into a different type of tissue. In the case of respiratory epithelium, it can transform into stratified squamous epithelium. This transformation occurs when the cilia on the columnar cells are lost, and the cells become squamous in shape.

      This transformation can be problematic, as the squamous cells can become dysplastic and lead to the development of squamous cell carcinoma in the lungs. Small cell carcinoma is another type of cancer that affects epithelial tissue, but its exact origin is not clear.

      Different types of epithelial tissue can be found in various parts of the body. Simple columnar epithelium, for example, is commonly found in the stomach. Simple cuboidal epithelium lines the reproductive organs, such as the ovaries and testes. Small cell epithelium lines the large and small intestines, while transitional epithelium can be found in the bladder.

      the different types of epithelial tissue and their potential for metaplasia can help in the diagnosis and treatment of various diseases and conditions.

    • This question is part of the following fields:

      • Clinical Sciences
      26.1
      Seconds
  • Question 10 - To which major food group does the molecule CH3CH(NH2)COOH belong? ...

    Correct

    • To which major food group does the molecule CH3CH(NH2)COOH belong?

      Your Answer: Protein

      Explanation:

      The Basics of Amino Acids and Alanine

      Amino acids are the building blocks of proteins, which are essential for the functioning of living organisms. One such amino acid is alanine, also known as CH3CH(NH2)COOH. The basic structure of an amino acid consists of an amine group (NH2) and a carboxylic acid group (COOH), which are both acidic and basic, respectively. These groups combine to give proteins a unique set of characteristics.

      Alanine is a simple amino acid with a methyl group in its R region. The formula for proteins is R-CH-NH2COOH, where R is a variable region. Amino acids combine to form dipeptides and polypeptides, which make up proteins. the basics of amino acids and their structures is crucial in the complex nature of proteins and their functions in living organisms.

    • This question is part of the following fields:

      • Clinical Sciences
      15.4
      Seconds
  • Question 11 - A 25-year-old male is brought in after a possible heroin overdose. His friend...

    Correct

    • A 25-year-old male is brought in after a possible heroin overdose. His friend discovered him on the floor of his apartment, where he may have been for a full day. The patient is groggy but responsive and reports experiencing muscle soreness. The medical team suspects rhabdomyolysis and wants to conduct a blood test to assess muscle damage. What specific blood test would be helpful in this evaluation?

      Your Answer: Creatine kinase

      Explanation:

      Rhabdomyolysis: Causes and Consequences

      Rhabdomyolysis is a serious medical condition that occurs when muscle cells break down and release their contents into the interstitial space. This can lead to a range of symptoms, including muscle pain and weakness, hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia, and brown discoloration of the urine. In severe cases, rhabdomyolysis can cause cardiac arrhythmias, renal failure, and disseminated intravascular coagulation (DIC).

      There are many different factors that can trigger rhabdomyolysis, including crush injuries, toxic damage, drugs and medications, severe electrolyte disturbances, reduced blood supply, ischemia, electric shock, heat stroke, and burns. One of the key diagnostic markers for rhabdomyolysis is elevated levels of creatine kinase in the blood.

      Treatment may involve addressing the underlying cause of the muscle breakdown, managing electrolyte imbalances, and providing supportive care to prevent complications. By the causes and consequences of rhabdomyolysis, individuals can take steps to protect their health and seek prompt medical attention if necessary.

    • This question is part of the following fields:

      • Clinical Sciences
      29.6
      Seconds
  • Question 12 - What is the accurate statement about Purkinje fibers in the myocardium? ...

    Incorrect

    • What is the accurate statement about Purkinje fibers in the myocardium?

      Your Answer: All of the above

      Correct Answer: Have a conduction velocity about four to six times the rate seen in heart muscle

      Explanation:

      Purkinje Fibres: Conductors of the Cardiac Impulse

      Purkinje fibres are specialized muscle fibres found in the ventricular myocardium of the heart. These fibres are responsible for conducting the cardiac impulse at a much faster rate than normal cardiac muscle, typically four to six times faster. Unlike neuronal axons, Purkinje fibres are not myelinated.

      Disorders of Purkinje fibres can lead to various arrhythmias, including ventricular fibrillation, even in patients with structurally normal hearts. It is important to understand the role of Purkinje fibres in the heart’s electrical conduction system to diagnose and treat these conditions effectively. Proper functioning of Purkinje fibres is crucial for maintaining a healthy heart rhythm.

    • This question is part of the following fields:

      • Clinical Sciences
      36.2
      Seconds
  • Question 13 - How can we describe the structure of the cell membrane? This vital component...

    Incorrect

    • How can we describe the structure of the cell membrane? This vital component is present in all mammalian cells and is composed of lipids, proteins, carbohydrates, and other structures. The arrangement of these components is often referred to as the fluid mosaic model.

      Your Answer: A phospholipid bilayer supported by an extracellular cytoskeleton of microfilaments and microtubules

      Correct Answer: A phospholipid bilayer with hydrophobic tails directly apposed with the hydrophilic heads facing the cytosolic and extracellular environments

      Explanation:

      The Fluid Mosaic Model of the Cell Membrane

      The cell membrane is composed of a bilayer of phospholipids with hydrophilic heads and hydrophobic tails. This arrangement allows for the passive diffusion of hydrophobic molecules while preventing the transfer of polar solutes. Cholesterol is also present in the membrane, with higher concentrations leading to greater insulation. The cell membrane is supported by a complex network of microtubules and microfilaments, which can assist in modulating the cell’s shape and allow for endocytosis and exocytosis. These processes involve the invagination of the substrate and formation of a vesicle before expelling it into the intracellular or extracellular compartment. The cytoskeleton also plays a role in internal scaffolding, cilia, filopodia, and microvilli. The fluid mosaic model of the cell membrane describes the arrangement of these components as a floating sandwich with the heads facing the cytosolic and extracellular compartments.

    • This question is part of the following fields:

      • Clinical Sciences
      84.2
      Seconds
  • Question 14 - A 57-year-old man falls from a ladder and suffers a calcaneal fracture that...

    Incorrect

    • A 57-year-old man falls from a ladder and suffers a calcaneal fracture that requires surgical treatment. During the surgery, an incision is made on the lateral side of the ankle. What anatomical structure would be visible behind the lateral malleolus?

      Your Answer: Flexor digitorum longus tendon

      Correct Answer: Peroneus longus tendon

      Explanation:

      The tendons of peroneus longus and brevis pass behind the lateral malleoli, while the structures passing behind the medial malleolus include the tibialis posterior tendon, flexor digitorum longus tendon, posterior tibial artery, vein, and nerve, and the flexor hallucis longus tendon.

    • This question is part of the following fields:

      • Clinical Sciences
      32.9
      Seconds
  • Question 15 - A 28-year-old individual is currently undergoing tuberculosis treatment and is being administered vitamin...

    Incorrect

    • A 28-year-old individual is currently undergoing tuberculosis treatment and is being administered vitamin B6 (pyridoxine). What is the primary function of vitamin B6 in the human body?

      Vitamin B6, also known as pyridoxine, plays a crucial role in various bodily functions. It is essential for the metabolism of amino acids, which are the building blocks of proteins. Vitamin B6 also aids in the production of neurotransmitters, such as serotonin and dopamine, which are responsible for regulating mood and behavior. Additionally, it is involved in the synthesis of hemoglobin, which is the protein in red blood cells that carries oxygen throughout the body. Therefore, the administration of vitamin B6 as part of tuberculosis treatment may help support the body's immune system and aid in the recovery process.

      Your Answer: Bone growth

      Correct Answer: Production of serotonin

      Explanation:

      The Importance of Vitamin B6 in the Human Body

      Vitamin B6, also known as pyridoxine, plays a crucial role in various functions of the human body. One of its primary functions is the production of neurotransmitters such as serotonin, dopamine, and norepinephrine, which are essential for regulating mood, behavior, and cognitive processes. Additionally, vitamin B6 acts as a cofactor in cellular reactions required for collagen synthesis, lipid metabolism, and red blood cell function.

      The body’s requirement for vitamin B6 increases during periods of growth, pregnancy, and lactation. Consumption of coffee and alcohol, smoking, and certain chronic diseases can also increase the body’s need for this vitamin. Moreover, a high protein diet and administration of certain medications, including azathioprine, corticosteroids, chloramphenicol, oestrogens, levo dopa, isoniazid, penicillamine, and phenytoin, can also increase the body’s demand for vitamin B6.

      In some cases, pyridoxine supplementation is necessary, especially for individuals taking isoniazid for tuberculosis. The long treatment regimen required to eliminate tuberculosis increases the risk of vitamin B6 deficiency. Therefore, it is essential to ensure adequate intake of vitamin B6 through a balanced diet or supplementation to maintain optimal health.

    • This question is part of the following fields:

      • Clinical Sciences
      75.5
      Seconds
  • Question 16 - A woman in her 30s presents with an elevated alkaline phosphatase (ALP) level...

    Correct

    • A woman in her 30s presents with an elevated alkaline phosphatase (ALP) level during pregnancy. All other liver function tests are within normal range and she reports feeling well. What is the probable cause of this finding?

      Your Answer: Placental production of ALP

      Explanation:

      Alkaline Phosphatase and Its Causes

      Alkaline phosphatase is an enzyme that can be found in various tissues in the body, making it a common part of liver function tests. An elevated level of ALP can be caused by different factors, including isoenzymes from the liver or bone, as well as the placenta in pregnant women. In children, elevated ALP levels are usually physiological and signify bone growth. However, transient hyperphosphatasia of infancy can cause a more dramatic increase in ALP, which is benign and resolves after a few months.

      Liver disease can also cause an increase in ALP, particularly with hepatobiliary obstruction, such as pancreatic carcinoma or a gallstone in the common bile duct. When bile drainage is obstructed, ALP synthesis increases significantly. On the other hand, liver diseases that predominantly cause hepatocellular damage will cause a lesser degree of ALP elevation.

      ALP also aids in the calcification process in bone and is found in osteoblasts. Therefore, any disease affecting bone turnover and calcification, including Paget’s disease, vitamin D deficiency, primary and secondary hyperparathyroidism, bone malignancies, and fracture healing, can cause abnormal ALP levels. Paget’s disease, which involves increased bone turnover, is a relatively common finding in older patients and can cause various symptoms such as tender bone/skull overgrowth, sensorineural deafness, pathological fractures, and rarely, high output cardiac failure.

      In summary, the causes of elevated ALP levels can help in diagnosing and managing various conditions affecting the liver and bone.

    • This question is part of the following fields:

      • Clinical Sciences
      34.5
      Seconds
  • Question 17 - What is a common clinical feature that is linked to hypovolemia? ...

    Incorrect

    • What is a common clinical feature that is linked to hypovolemia?

      Your Answer: Increased jugular venous pressure

      Correct Answer: Dry mucous membranes

      Explanation:

      Hypovolaemia

      Hypovolaemia is a condition that occurs when there is a decrease in the volume of blood in the body. This can be caused by severe dehydration, poor oral fluid intake, excessive fluid losses in diarrhoea or through stomas, and major haemorrhage. The symptoms of hypovolaemia include dry mucous membranes, normal or increased sodium concentration in the blood, reduced jugular venous pressure, reduced urinary flow rate, and increased respiratory rate.

      Dry mucous membranes are not a highly discriminating feature of hypovolaemia. The effect of hypovolaemia on sodium concentrations is highly variable. If hypovolaemia results from the loss of blood or fluid containing isotonic amounts of sodium, the sodium concentration is likely to stay within the reference range. However, if hypovolaemia is due to prolonged poor oral intake, hypernatraemia can result. Hypovolaemia alone is generally not associated with hyponatraemia unless there is concomitant infection, inflammation, or loss of sodium-rich fluids, for example, from a high-output stoma.

      Reduced jugular venous pressure is a common symptom of hypovolaemia. The low circulating volume will cause a low JVP. In normal circumstances, the body responds to hypovolaemia by reducing urinary flow rates. If circulation is impaired by loss of blood, a common response is an increase in the respiratory rate. This is often an early feature of significant blood loss. the symptoms of hypovolaemia is important for prompt diagnosis and treatment.

    • This question is part of the following fields:

      • Clinical Sciences
      19.7
      Seconds
  • Question 18 - What is a correct statement regarding meta-analysis? ...

    Correct

    • What is a correct statement regarding meta-analysis?

      Your Answer: The weight of each study should depend on the sample size

      Explanation:

      Factors Considered in Meta-Analysis

      Meta-analysis is a statistical technique used to combine the results of multiple studies on a particular topic. When conducting a meta-analysis, the sample size of each study is taken into account for weighting purposes. This means that studies with larger sample sizes will have a greater impact on the final result than studies with smaller sample sizes.

      It is possible to perform a meta-analysis on aggregate data, as long as there is enough information available. However, it is not necessary to exclude studies with missing data. The effect size of each study should not affect its weight in the meta-analysis, but it will impact the overall result.

      In the past, trial quality was often incorporated into meta-analysis weightings. However, this practice has become less common as it can be subjective and arbitrary. Overall, the sample size of each study is the most important factor to consider when conducting a meta-analysis.

    • This question is part of the following fields:

      • Clinical Sciences
      42
      Seconds
  • Question 19 - A 58-year-old patient presents to the clinic with a chief complaint of reduced...

    Incorrect

    • A 58-year-old patient presents to the clinic with a chief complaint of reduced night vision. Upon further examination, it is discovered that the patient has a medical history of pancreatic insufficiency, chronic diarrhea, and malabsorption. Can you identify which vitamin deficiency is commonly linked to issues with night vision?

      Your Answer: Vitamin E

      Correct Answer: Vitamin A

      Explanation:

      The Role of Vitamin A in Night Vision

      Vitamin A is essential for the production of rhodopsin, a protein found in the retina that is responsible for converting light into energy. This process involves the conversion of vitamin A into 11-cis retinal or all-trans retinol, which is stored in the pigment layer of the retina. Isomerase is an enzyme that plays a crucial role in the production of 11-cis retinal, which is then used to produce rhodopsin.

      A deficiency in vitamin A can lead to a problem with night vision, as the body is unable to produce enough rhodopsin to respond to changes in light. This can result in difficulty seeing in low light conditions, such as when driving at night or in dimly lit environments. It is important to ensure that the body receives an adequate amount of vitamin A through a balanced diet or supplements to maintain healthy vision.

    • This question is part of the following fields:

      • Clinical Sciences
      18.9
      Seconds
  • Question 20 - What is the leading reason for hypoglycemia in adults? ...

    Incorrect

    • What is the leading reason for hypoglycemia in adults?

      Your Answer: Insulinoma

      Correct Answer: Treated diabetes mellitus

      Explanation:

      Hypoglycaemia in Adults

      Hypoglycaemia is a condition where the blood glucose level falls below the typical fasting level, which is around <4 mmol/L for an adult. This condition can cause various symptoms, including tremors, sweating, nausea, lightheadedness, hunger, and disorientation. Severe hypoglycaemia can even lead to confusion, aggressive behaviour, and reduced consciousness. Drug-treated diabetes mellitus is the most common cause of hypoglycaemia in adults, especially due to insulin or hypoglycaemia drugs like sulphonylureas. Type 1 diabetes patients are at a higher risk of hypoglycaemia due to hypoglycaemia unawareness and blunted glucagon response. However, mild hypoglycaemia is common during fasting, pregnancy, and minor illness. Apart from diabetes, other causes of hypoglycaemia in adults include non-diabetic drugs, alcohol, hepatic failure, critical illness, hormone deficiency, malignancy, insulinoma, non-insulinoma pancreatogenous hypoglycaemia syndrome (NIPHS), and bariatric surgery. It is essential to understand the causes and symptoms of hypoglycaemia to manage the condition effectively. Early diagnosis and treatment can prevent severe complications and improve the quality of life for individuals with hypoglycaemia.

    • This question is part of the following fields:

      • Clinical Sciences
      16.2
      Seconds
  • Question 21 - Which type of lipoprotein is involved in the development of atherosclerosis observed in...

    Correct

    • Which type of lipoprotein is involved in the development of atherosclerosis observed in coronary artery disease?

      Your Answer: Low density lipoprotein (LDL)

      Explanation:

      Atherosclerosis: The Gradual Narrowing of Arteries

      Atherosclerosis is a gradual process that involves the narrowing of arteries due to the accumulation of lipid-rich deposits within artery walls. This condition can take many years to develop and is the primary cause of coronary heart disease, peripheral vascular disease, and ischemic stroke. When a clot forms over an atherosclerotic plaque, it can lead to a heart attack by blocking blood flow to the cardiac muscle.

      Monocytes from the blood absorb oxidized LDL particles to form lipid-laden foam cells, which accumulate in the vessel walls and eventually form fatty streaks and atherosclerotic plaques. These foam cells secrete cytokines and chemokines that promote smooth muscle cell proliferation, contributing to the development of the atherosclerotic plaque. Any damage to the plaque can result in the release of tissue factor, which promotes clot formation.

      LDL can easily form oxidized LDL, especially in the presence of haem, which is released from damaged red blood cells in areas of turbulent blood flow. Inflammation, obesity, diabetes, and impaired glucose tolerance can also contribute to the formation of oxidized LDL. the causes and mechanisms of atherosclerosis is crucial in preventing and treating this condition.

    • This question is part of the following fields:

      • Clinical Sciences
      14.6
      Seconds
  • Question 22 - A patient with familial hypercholesterolaemia who is 45 years old is undergoing treatment...

    Incorrect

    • A patient with familial hypercholesterolaemia who is 45 years old is undergoing treatment with high dose nicotinic acid, a derivative of vitamin B3 (niacin).

      What are the primary side effects that can be anticipated with this therapy?

      Your Answer: Diarrhoea

      Correct Answer: Flushing

      Explanation:

      The Functions and Uses of Nicotinic Acid

      Nicotinic acid is a medication used to treat dyslipidaemia, a condition characterized by abnormal levels of lipids in the blood. It works by increasing high-density lipoprotein cholesterol (HDLc) and reducing low-density lipoprotein cholesterol (LDLc). However, high doses of nicotinic acid can cause flushing, a side effect that can be improved by co-administering laropiprant. On the other hand, niacin deficiency can lead to anxiety, diarrhea, and skin rashes on sun-exposed sites, while muscle aches are common with statins, another group of lipid-lowering agents.

      Aside from its therapeutic uses, nicotinic acid and its derivatives have various functions within the body. It serves as a cofactor in cellular reactions, particularly in the metabolism of fatty acids and steroid hormones. It also acts as an antioxidant, protecting the liver against free radical damage. Moreover, niacin is required for DNA replication and repair, as well as for the synthesis of histone proteins that facilitate DNA storage, replication, and repair. Additionally, niacin plays a role in lipid metabolism and has been used as a lipid-lowering agent. Although poorly understood, niacin may also have a role in the regulation of blood sugar concentrations.

      Overall, nicotinic acid is a versatile medication with various functions and uses in the body. Its therapeutic benefits in dyslipidaemia are significant, but its side effects should also be considered. the different roles of niacin in the body can provide insights into its potential uses in other conditions.

    • This question is part of the following fields:

      • Clinical Sciences
      38.6
      Seconds
  • Question 23 - Ms. Johnson is a 35-year-old asthmatic woman with severe community acquired pneumonia. She...

    Incorrect

    • Ms. Johnson is a 35-year-old asthmatic woman with severe community acquired pneumonia. She has been admitted to the intensive care unit for cardiovascular support. Currently, her blood pressure is 80/64 mmHg, heart rate is 128 bpm, and cardiac output is 3.2 L/min. Ms. Johnson is receiving 15 L/min of oxygen through a facemask and has oxygen saturations of 88% with a respiratory rate of 16. Her temperature is 39.6°C. What is the estimated stroke volume for Ms. Johnson?

      Your Answer: 40 ml

      Correct Answer: 25 ml

      Explanation:

      Cardiac Output and its Relationship to Health Conditions

      Cardiac output is the product of heart rate and stroke volume. Stroke volume can be calculated by dividing cardiac output by heart rate. The average cardiac output is 5 liters per minute, with a normal stroke volume ranging from 50-85 milliliters per beat, depending on heart rate.

      When a person experiences poor oxygen saturation and a normal respiratory rate, it may indicate that they are becoming exhausted and unable to breathe rapidly. This, combined with low blood pressure, tachycardia, and a failure to maintain cardiac output, can be indicative of shock. Additionally, a high temperature may suggest severe sepsis secondary to pneumonia.

      cardiac output and its relationship to various health conditions can help medical professionals diagnose and treat patients more effectively. By monitoring heart rate, stroke volume, and other vital signs, healthcare providers can identify potential issues and intervene before they become life-threatening. Proper management of cardiac output is crucial for maintaining overall health and preventing serious complications.

    • This question is part of the following fields:

      • Clinical Sciences
      42.2
      Seconds
  • Question 24 - A 67-year-old man presents with symptoms of altered bowel habit and weight loss...

    Incorrect

    • A 67-year-old man presents with symptoms of altered bowel habit and weight loss for the past eight weeks. After undergoing screening for faecal occult blood, he is diagnosed with colorectal carcinoma. A biopsy reveals that the tumour has invaded the muscularis propria, but there is no evidence of metastases in the local lymph nodes. What is the likely stage of this cancer?

      Your Answer: Duke's stage C

      Correct Answer: Duke's stage B

      Explanation:

      Duke’s Staging and Prognostic Value

      Duke’s staging system is a useful tool in predicting the prognosis of colorectal cancer patients. The system was developed by Cuthbert Duke, a pathologist from the United Kingdom, in the 1930s. The staging system is based on the extent of tumor invasion and lymph node involvement.

      Stage A refers to tumors that are confined to the mucosa, with a five-year survival rate of 90%. Stage B includes tumors that have invaded through the muscularis propria but have no lymph node involvement, with a five-year survival rate of 60%. Stage C includes tumors that have spread to the lymph nodes, with a five-year survival rate of 30%. Finally, stage D describes patients with metastatic disease.

      The Duke’s staging system is a valuable tool for clinicians in determining the prognosis of colorectal cancer patients. It provides a clear of the extent of the disease and helps in making treatment decisions. The system has been widely used for many years and has proven to be a reliable predictor of survival rates.

    • This question is part of the following fields:

      • Clinical Sciences
      23.7
      Seconds
  • Question 25 - In which type of liver cells do oxygen-dependent metabolic reactions occur mostly? ...

    Incorrect

    • In which type of liver cells do oxygen-dependent metabolic reactions occur mostly?

      Your Answer: Zone 2 hepatocytes

      Correct Answer: Zone 1 hepatocytes

      Explanation:

      The Liver’s Dual Blood Supply and Cell Zones

      The liver is composed of small units called acini, each with a dual blood supply from the hepatic artery and portal vein. The blood flows through the hepatic sinusoids, allowing solutes and oxygen to move freely into the hepatocytes. The blood eventually drains into the hepatic vein and back into the systemic circulation.

      The hepatocytes in the periportal region, closest to the hepatic arterial and portal vein supply, are called zone 1 hepatocytes. They are highly metabolically active due to their oxygen-rich and solute-rich supply, but are also more susceptible to damage from toxins. Zone 1 hepatocytes are responsible for oxygen-requiring reactions such as the electron transport chains, Krebs’ cycle, fatty acid oxidation, and urea synthesis.

      Zone 2 and 3 hepatocytes receive less oxygen and are involved in reactions requiring little or no oxygen, such as glycolysis. Ito cells store fats and vitamin A and are involved in the production of connective tissue. Kupffer cells, specialized macrophages, are part of the reticuloendothelial system and are involved in the breakdown of haemoglobulin and the removal of haem for further metabolism in the hepatocytes. Kupffer cells also play a role in immunity. In liver disease, Ito cells are thought to be fundamental in the development of fibrosis and cirrhosis.

      Overall, the liver’s dual blood supply and cell zones play important roles in the metabolic and immune functions of the liver.

    • This question is part of the following fields:

      • Clinical Sciences
      29
      Seconds
  • Question 26 - A 78-year-old man is involved in a car accident and suffers an injury...

    Correct

    • A 78-year-old man is involved in a car accident and suffers an injury to his sternum. He experiences tenderness around the manubriosternal joint.
      What is the classification of the manubriosternal joint?

      Your Answer: A symphysis

      Explanation:

      Types of Joints

      There are different types of joints in the human body. The manubriosternal joint is a secondary cartilaginous joint, also known as a symphysis. It has two articular surfaces covered with hyaline cartilage and connected by fibrocartilage. On the other hand, a double synovial joint has two separate synovial cavities separated by an articular disk that allows for flexibility and movement. An example of this is the Tempromandibular joint.

      Meanwhile, a fibrous joint is connected by fibrous tissue, mainly consisting of collagen, and is fixed. A primary cartilaginous joint is where two bones are joined by hyaline cartilage. Lastly, a single synovial joint is surrounded by a fibrous joint capsule that is continuous with the periosteum of the joined bones and contains synovial fluid.

      In summary, the different types of joints in the human body have varying structures and functions. these joints is essential in diagnosing and treating joint-related conditions.

    • This question is part of the following fields:

      • Clinical Sciences
      14.7
      Seconds
  • Question 27 - In which part of the gastrointestinal system is water mainly taken up? ...

    Incorrect

    • In which part of the gastrointestinal system is water mainly taken up?

      Your Answer: Transverse colon

      Correct Answer: Small intestine

      Explanation:

      The Function of the Large Intestine

      Although many people believe that the primary function of the large intestine is to absorb water, this is not entirely accurate. In fact, the majority of water and fluids that are ingested or secreted are actually reabsorbed in the small intestine, which is located before the large intestine in the digestive tract. While the large intestine does play a role in absorbing some water and electrolytes, its primary function is to store and eliminate waste products from the body. This is achieved through the formation of feces, which are then eliminated through the rectum and anus. Overall, while the large intestine is an important part of the digestive system, its function is more complex than simply absorbing water.

    • This question is part of the following fields:

      • Clinical Sciences
      12.2
      Seconds
  • Question 28 - A study was conducted to investigate the relationship between television watching and lung...

    Correct

    • A study was conducted to investigate the relationship between television watching and lung cancer. The results showed that individuals who watched television for over five hours per day had a 30% higher risk of developing lung cancer (p=0.01). Additionally, these individuals were more likely to be smokers (p=0.02). What is the correct statement regarding these findings?

      Your Answer: The risk of lung cancer for patients who watched television for more than five hours a day will reduce if smokers are excluded from analysis

      Explanation:

      The Relationship between Television Watching and Lung Cancer

      The relationship between television watching and lung cancer is not straightforward. While it may appear that watching television for more than five hours a day increases the risk of lung cancer, there are confounding factors that need to be considered. Smoking, for example, is a significant confounder since it is associated with both television watching and lung cancer.

      To determine the true relationship between television watching and lung cancer, further analyses of results are needed. It is insufficient to simply exclude smokers from the study since the information given in the question is not enough to make such a conclusion. While previous studies have shown that smoking is associated with lung cancer, we cannot assume that this is the only factor at play.

      In summary, while it may seem that watching television for extended periods of time increases the risk of lung cancer, significant confounding by smoking is present. Therefore, we cannot conclude that watching television is a significant risk factor for lung cancer without further analysis.

    • This question is part of the following fields:

      • Clinical Sciences
      45.9
      Seconds
  • Question 29 - A 42-year-old man is brought to the Emergency department from a rehabilitation center...

    Correct

    • A 42-year-old man is brought to the Emergency department from a rehabilitation center where he is receiving treatment for alcohol addiction. Upon examination, he is diagnosed with hypomagnesaemia. What are the possible symptoms that can arise due to this condition?

      Your Answer: Palpitations

      Explanation:

      Hypomagnesaemia: Causes, Symptoms, and Treatment

      Hypomagnesaemia, or low levels of magnesium in the blood, is a common electrolyte disturbance among inpatients. It can lead to serious complications, particularly cardiac arrhythmia, which can result in cardiac arrest. The condition is often caused by gastrointestinal loss of magnesium due to vomiting, high output stomas, fistulae, and malabsorption disorders. Poor nutritional input, renal losses of magnesium, and primary renal diseases can also contribute to hypomagnesaemia.

      Mild magnesium deficiency usually results in few or no symptoms, but severe deficiency can cause hypokalaemia and hypocalcaemia, as well as overlapping clinical features with hypocalcaemia and hypokalaemia. These symptoms include tetany, neuromuscular excitability, hypertonicity, palpitations, fatigue, and cardiac arrhythmias.

      Mild hypomagnesaemia can be treated with oral magnesium salts, while severe cases require cautious intravenous correction. It is important to monitor and correct magnesium levels to prevent the development of cardiac dysrhythmia and cardiac arrest.

    • This question is part of the following fields:

      • Clinical Sciences
      21.6
      Seconds
  • Question 30 - What is the primary function of niacin, also known as vitamin B3? ...

    Incorrect

    • What is the primary function of niacin, also known as vitamin B3?

      Your Answer: Regulation of calcium homeostasis

      Correct Answer: Antioxidant function

      Explanation:

      The Many Functions of Niacin in the Body

      Niacin, also known as vitamin B3, plays a crucial role in various processes within the body. It acts as a cofactor in cellular reactions, aiding in the metabolism of fatty acids and steroid hormones. Additionally, niacin functions as an antioxidant, protecting the liver from free radical damage. It is also required for DNA replication and repair, as it is necessary for the synthesis of histone proteins that facilitate DNA storage, replication, and repair.

      Furthermore, niacin is involved in lipid metabolism and cholesterol regulation, with high doses of niacin being used as a lipid-lowering agent. Although not fully understood, niacin may also have a role in regulating blood sugar concentrations.

      Niacin can be obtained through the diet in two forms: nicotinic acid and nicotinamide. The body can also produce its own niacin from tryptophan, an amino acid found in protein-rich foods. With its numerous functions, niacin is an essential nutrient for maintaining optimal health.

    • This question is part of the following fields:

      • Clinical Sciences
      19.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Clinical Sciences (12/30) 40%
Passmed