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  • Question 1 - A patient suffers an injury to the nerve that innervates piriformis.The piriformis muscle...

    Incorrect

    • A patient suffers an injury to the nerve that innervates piriformis.The piriformis muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: Sciatic nerve

      Correct Answer: Nerve to piriformis

      Explanation:

      Piriformis is innervated by the nerve to piriformis, which is a direct branch from the sacral plexus (S1 and S2).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      61.6
      Seconds

  • Question 2 - Before a patient is discharged, you are asked to review them. He is...

    Correct

    • Before a patient is discharged, you are asked to review them. He is a 59-year-old man who was seen with epigastric pain that has since subsided, and he will be seen by his GP in the coming days. He's been hearing a lot about aspirin lately and wants to learn more about it.Which of the following statements about aspirin's mechanism of action is correct?

      Your Answer: Inhibition of cyclo-oxygenase

      Explanation:

      Aspirin works by inhibiting cyclo-oxygenase in an irreversible manner, resulting in a decrease in prostaglandin and thromboxane production. As a result, platelet activation and aggregation are reduced.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      24.1
      Seconds

  • Question 3 - A 26-year old female comes to the Emergency Room with complaints of bloody...

    Incorrect

    • A 26-year old female comes to the Emergency Room with complaints of bloody stools. She reports that prior to the passage of bloody stools, she experienced a sharp pain during defecation. Medical history reveals that she has been experiencing constipation for the past 2 weeks. After completing her medical history and physical examination, the attending physician gives an initial diagnosis of an anal fissure.Which of the following nerves transmit painful sensation from the anus, resulting in the pain associated with anal fissure?

      Your Answer: Perineal nerve

      Correct Answer: Inferior rectal nerve

      Explanation:

      A fissure in ano is a tear in the anoderm distal to the dentate line. The pathophysiology of anal fissure is thought to be related to trauma from either the passage of hard stool or prolonged diarrhoea. A tear in the anoderm causes spasm of the internal anal sphincter, which results in pain, increased tearing, and decreased blood supply to the anoderm. The site of the anal fissure in the sensitive lower half of the anal canal, which is innervated by the inferior rectal nerve, results in reflex spasm of the external anal sphincter, aggravating the condition. Because of the intense pain, anal fissures may have to be examined under local anaesthesia.The inferior rectal nerve is a branch of the pudendal nerve. This nerve runs medially across the ischiorectal fossa and supplies the external anal sphincter, the mucous membrane of the lower half of the anal canal, and the perianal skin.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      33
      Seconds

  • Question 4 - A 67-year-old female is admitted under your care with the complaint of shortness...

    Incorrect

    • A 67-year-old female is admitted under your care with the complaint of shortness of breath and massive pedal oedema. There are fine crepitations up to the mid zones on both lung fields on chest auscultation. When questioned about her medication, she doesn't remember everything she takes but knows that there is a tablet to get rid of excess water. Out of the following medications, which one increases the osmolality of the filtrate in the glomerulus and the tubule, creating an osmotic effect?

      Your Answer: Spironolactone

      Correct Answer: Mannitol

      Explanation:

      Mannitol is an osmotic diuretic that stops the absorption of water throughout the tubule, thus increasing the osmolality of both glomerular and tubular fluid. It is used to:1. decrease intraocular pressure in glaucoma 2. decrease intracerebral pressure3. oliguria. Furosemide is a loop diuretic that inhibits the Na/K/2Cl transported in the ascending limb of the Loop of Henle. Bendroflumethiazide is a thiazide diuretic which inhibits the Na/Cl transporter. Spironolactone is a potassium-sparing diuretic that acts as an aldosterone receptor antagonist. Acetazolamide is a carbonic anhydrase inhibitor.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      28.5
      Seconds

  • Question 5 - Gastrin primarily acts to perform which of the following functions: ...

    Correct

    • Gastrin primarily acts to perform which of the following functions:

      Your Answer: Stimulate gastric acid secretion

      Explanation:

      Gastrin primarily  acts to stimulate acid secretion from parietal cells (both directly and indirectly by stimulating release of histamine from ECL cells).

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      10.3
      Seconds

  • Question 6 - A patient suffers an injury to his thigh that damages the nerve that...

    Incorrect

    • A patient suffers an injury to his thigh that damages the nerve that innervates pectineus.Which of the following nerves has been damaged in this case? Select ONE answer only.

      Your Answer:

      Correct Answer: Femoral nerve

      Explanation:

      Pectineus is innervated by the femoral nerve. It may also receive a branch from the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 7 - Regarding Clostridium tetani, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding Clostridium tetani, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Metronidazole is usually the antibiotic of choice for tetanus infection.

      Explanation:

      Clostridium tetani infection is predominantly derived from animal faeces and soil.  Clostridium tetani has exotoxin-mediated effects, predominantly by tetanospasmin which inhibits the release of GABA at the presynaptic membrane throughout the central and peripheral nervous system. Metronidazole has overtaken penicillin as the antibiotic of choice for treatment of tetanus (together with surgical debridement, tetanus toxoid immunisation, and human tetanus immunoglobulin).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 8 - An ambulance transports a 23-year-old woman who has taken a witnessed overdose of...

    Incorrect

    • An ambulance transports a 23-year-old woman who has taken a witnessed overdose of her mother's diazepam tablets. She has no significant medical history and does not take any medications on a regular basis.In this case, what is the SINGLE MOST APPROPRIATE FIRST DRUG TREATMENT?

      Your Answer:

      Correct Answer: Flumazenil IV 200 μg

      Explanation:

      Flumazenil is a benzodiazepine antagonist that can be helpful in some overdose situations. It works quickly (in less than a minute), but the effects are fleeting, lasting less than an hour. The dose is 200 micrograms every 1-2 minutes with a maximum dose of 3 milligrams per hour.Flumazenil should be avoided by patients who are addicted to benzodiazepines or who take tricyclic antidepressants because it can cause withdrawal symptoms. It can cause seizures or cardiac arrest in these situations.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 9 - Which statement regarding skeletal muscle is true? ...

    Incorrect

    • Which statement regarding skeletal muscle is true?

      Your Answer:

      Correct Answer: Myosin is the major constituent of the thick filament

      Explanation:

      Myosin is the major constituent of the thick filament. Actin is the major constituent of the THIN filament. Thin filaments consist of actin, tropomyosin and troponin in the ratio 7:1:1.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      0
      Seconds

  • Question 10 - A patient with a diagnosis of HIV presents with a fever, sore throat,...

    Incorrect

    • A patient with a diagnosis of HIV presents with a fever, sore throat, and general malaise and you are concerned the patient may have an AIDS defining illness.Which one of these, according to the CDC definition, would mean a patient infected with HIV has AIDS?

      Your Answer:

      Correct Answer: CD4 T-cell percentage of total lymphocytes of less than 15%

      Explanation:

      According to the CDC definition, a patient co-infected with HIV can be diagnosed with AIDS if he or she has:A CD4 T-cell count of less than 200 cells/mm3 or;A CD4 T-cell percentage of total lymphocytes of less than 15% or;An AIDS defining infectionA Streptococcal throat infection is not an AIDS defining infection.A normal CD4 count ranges from 500-1000 cells/mm3. A CD4 (not CD8) count of less than 200 cells/mm3 is AIDS defining.The CD4 count can vary from day to day and depending upon the time that the blood test is taken. It can also be affected by the presence of other infections or illnesses. Treatment with anti-retroviral therapy should be considered at CD4 count of less than 350 cells/mm3.Serum concentrations of the p24 antigen (the viral protein that makes up most of the core of the HIV) are usually high in the first few weeks after human immunodeficiency virus (HIV) infection and testing for p24 antigen is therefore a useful way of diagnosing very early infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 11 - A 70-year-old patient diagnosed with Cushing's syndrome and has a history of weight...

    Incorrect

    • A 70-year-old patient diagnosed with Cushing's syndrome and has a history of weight gain, hypertension, and easy bruising.Which of these assertions about Cushing's syndrome is correct?

      Your Answer:

      Correct Answer: Diagnosis can be confirmed by a dexamethasone suppression test

      Explanation:

      Cushing’s syndrome is a group of symptoms and signs brought on by long-term exposure to high amounts of endogenous or exogenous glucocorticoids.Iatrogenic corticosteroid injection is the most prevalent cause of Cushing’s syndrome. Cushing’s illness is the second most prevalent cause of Cushing’s syndrome. Cushing’s disease is distinct from Cushing’s syndrome in that it refers to a single cause of the illness, a pituitary adenoma that secretes high quantities of ACTH, which raises cortisol levels.Because cortisol enhances the vasoconstrictive impact of endogenous adrenaline, patients with Cushing’s syndrome are usually hypertensive.Hyperglycaemia (due to insulin resistance) rather than hypoglycaemia is a common symptom.Cortisol levels fluctuate throughout the day, with the greatest levels occurring around 0900 hours and the lowest occurring at 2400 hrs during sleep. The diurnal swing of cortisol levels is lost in Cushing’s syndrome, and levels are greater throughout the 24-hour period. In the morning, levels may be normal, but they may be high at night-time, when they are generally repressed.A dexamethasone suppression test or a 24-hour urine free cortisol collection can both be used to establish the existence of Cushing’s syndrome.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds

  • Question 12 - A 39-year-old man who is suffering from a bacterial infection require antibiotic treatment....

    Incorrect

    • A 39-year-old man who is suffering from a bacterial infection require antibiotic treatment. You need to figure out which antibiotic is most suitable. Listed below are antimicrobial drugs. Which one is a nucleic acid synthesis inhibitor?

      Your Answer:

      Correct Answer: Ciprofloxacin

      Explanation:

      Ciprofloxacin and other quinolone antibiotics work by blocking DNA gyrase, an enzyme that compresses bacterial DNA into supercoils, as well as a type II topoisomerase, which is required for bacterial DNA separation. As a result, they prevent nucleic acid synthesis.The following is a summary of the many modes of action of various types of antimicrobial agents:Action Mechanisms- Examples:Cell wall production is inhibitedVancomycinVancomycinCephalosporinsThe function of the cell membrane is disrupted NystatinPolymyxinsAmphotericin B Inhibition of protein synthesisChloramphenicolMacrolidesAminoglycosidesTetracyclinesNucleic acid synthesis inhibitionQuinolonesTrimethoprimRifampicin5-nitroimidazolesSulphonamidesAnti-metabolic activityIsoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 13 - Contraction of the diaphragm results in which of the following effects: ...

    Incorrect

    • Contraction of the diaphragm results in which of the following effects:

      Your Answer:

      Correct Answer: Increased vertical dimension of the thorax

      Explanation:

      Contraction of the diaphragm (as in inspiration) results in flattening (depression) of the diaphragm with an increase in vertical dimension of the thorax. This results in decreased intrathoracic pressure and increased intra-abdominal pressure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 14 - Regarding renal clearance, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding renal clearance, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: The MDRD equation uses plasma creatinine to estimate the GFR making an adjustment for age, sex and race.

      Explanation:

      Clearance is defined as the volume of plasma that is cleared of a substance per unit time. Inulin clearance is the gold standard for measurement of GFR but creatinine clearance is typically used instead. Creatinine is freely filtered and not reabsorbed, but there is a little creatinine tubular secretion. In practice, GFR is usually estimated from the plasma creatinine using a formula e.g. the MDRD equation making an adjustment for age, sex and race.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 15 - A 54-year-old woman presents with polyuria and polydipsia. She is known to suffer...

    Incorrect

    • A 54-year-old woman presents with polyuria and polydipsia. She is known to suffer from bipolar disorder, which has been well controlled by the use of lithium for many years.What is the SINGLE most likely diagnosis?

      Your Answer:

      Correct Answer: Nephrogenic diabetes insipidus

      Explanation:

      Diabetes insipidus is the inability to produce concentrated urine. It is characterised by the presence of excessive thirst, polyuria and polydipsia. There are two distinct types of diabetes insipidus:Cranial (central) diabetes insipidus and;Nephrogenic diabetes insipidusCranial diabetes insipidus is caused by a deficiency of vasopressin (anti-diuretic hormone). Patients with cranial diabetes insipidus can have a urine output as high as 10-15 litres per 24 hours, but adequate fluid intake allows most patients to maintain normonatraemia. 30% of cases are idiopathic, and a further 30% are secondary to head injuries. Other causes include neurosurgery, brain tumours, meningitis, granulomatous disease (e.g. sarcoidosis) and drugs, such as naloxone and phenytoin. A very rare inherited form also exists that is associated with diabetes mellitus, optic atrophy, nerve deafness and bladder atonia.Nephrogenic diabetes insipidus is caused by renal resistance to the action of vasopressin. As with cranial diabetes insipidus, urine output is markedly elevated. Serum sodium levels can be maintained by secondary polydipsia or can be elevated. Causes of nephrogenic diabetes insipidus include chronic renal disease, metabolic disorders (e.g. hypercalcaemia and hypokalaemia) and drugs, including long-term lithium usage and demeclocycline.In view of the history of long-term lithium use, in this case, nephrogenic diabetes insipidus is the most likely diagnosis.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      0
      Seconds

  • Question 16 - A patient presents with increased breathlessness and worsening of his chronic cough and....

    Incorrect

    • A patient presents with increased breathlessness and worsening of his chronic cough and. He has a chronic lung disorder and is on long-term oxygen therapy (LTOT).Which of these is an indication for LTOT?

      Your Answer:

      Correct Answer: A non-smoker with COPD and a PaO 2 of 7.5 kPa when stable with secondary polycythaemia

      Explanation:

      Long-term administration of oxygen, usually at least 15 hours daily, improves survival in COPD patients who have severe hypoxaemia. Long-term oxygen therapy should be considered in:A non-smoker with COPD and a PaO2<7.3 kPa when stableA non-smoker with COPD and PaO27.3–8 kPa when stable and with secondary polycythaemia, peripheral oedema, or evidence of pulmonary hypertensionSevere chronic asthma with PaO2<7.3 kPa or persistent disabling breathlessnessA patient with Interstitial lung disease with PaO28 kPa with disabling dyspnoeaA patient with cystic fibrosis when PaO2<7.3 kPa or if PaO27.3–8 kPa in the presence of secondary polycythaemia, nocturnal hypoxaemia, pulmonary hypertension, or peripheral oedemaPulmonary hypertension, without parenchymal lung involvement when PaO2<8 kPaNeuromuscular or skeletal disorders, after specialist assessmentObstructive sleep apnoea despite continuous positive airways pressure therapy, after specialist assessmentPulmonary malignancy or other terminal disease with disabling dyspnoeaHeart failure with daytime PaO2<7.3 kPa when breathing air or with nocturnal hypoxaemia

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds

  • Question 17 - Among the following infectious diseases, which is typically considered to have an incubation...

    Incorrect

    • Among the following infectious diseases, which is typically considered to have an incubation period of 3 weeks and longer?

      Your Answer:

      Correct Answer: Infectious mononucleosis

      Explanation:

      Infectious mononucleosis is caused by Epstein-Barr virus (EBV). The incubation period for EBV varies from 2 weeks to 2 months.The usual incubation period for rubella is 14 days; with a range of 12 to 23 days.Gonorrhoea has a short incubation period of approximately 2 to 7 days.The mumps virus can be isolated from infected saliva and swabs rubbed over the Stensen’s duct from 9 days before onset of symptoms until 8 days after parotitis appears.Scarlet fever, which appears within 1 to 2 days after bacterial infection, is characterized by a diffuse red rash that appears on the upper chest and spreads to the trunk and extremities. The rash disappears over the next 5 to7 days and is followed by desquamation.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 18 - A patient presents with a lump for a dermatological examination. There is a...

    Incorrect

    • A patient presents with a lump for a dermatological examination. There is a circumscribed skin elevation measuring 0.3 cm in diameter seen on examination.Which one of these best describes the lump you have found on examination?

      Your Answer:

      Correct Answer: Papule

      Explanation:

      A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter. A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless. A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter. A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus. A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds

  • Question 19 - A 4-year-old girl is rushed to the Emergency Department by her grandparents after...

    Incorrect

    • A 4-year-old girl is rushed to the Emergency Department by her grandparents after swallowing some of her grandfather's Warfarin tablets. On further questioning, it turns out that she took 5 of his 3 mg tablets which he needs to take due to a history of atrial fibrillation. The child appears healthy well-oriented in time, place and person, and has normal vitals. What is the threshold dose of Warfarin that needs to be ingested for there to be a risk of anticoagulation?

      Your Answer:

      Correct Answer: 0.5 mg/kg

      Explanation:

      The clinical effects of Warfarin occur after a dose of greater than 0.5 mg/kg, and they will be observable 8-10 hours after consumption of the drug. The antidote used for Warfarin is Vitamin K.1. In low-risk cases with no apparent bleeding: an oral dose of 10 mg vitamin K2. If there is clinically significant bleedingan intravenous dose of 250-300 mcg/kgActivated charcoal: in cases of warfarin ingestionbinds to it and reduces the absorption of warfarin the ingestion must have occurred within the last hourThere is, however, rarely a need for the use of activated charcoal because vitamin K is such as safe and effective antidote. Clotting studies, including an INR, can be performed, but small children who have ingested warfarin do not require INRs or follow up if they have been treated with 10 mg vitamin K. This dose of vitamin will completely reverse the anticoagulative effects of warfarin.Perform INR if any of the following are present:1. Delayed presentation (>6 hours)2. Patients with symptoms or signs of anticoagulation3. Possible massive ingestion

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 20 - A 24-year-old athlete drinks a 500 ml hypertonic sports drink before an endurance...

    Incorrect

    • A 24-year-old athlete drinks a 500 ml hypertonic sports drink before an endurance event he participates in.Which of the following effects will this cause?

      Your Answer:

      Correct Answer: The interstitial fluid becomes more concentrated

      Explanation:

      Osmosis is the passive movement of water across a semipermeable membrane from a region of low solute concentration to a region of higher solute concentration.When hypertonic fluid is ingested:The plasma becomes CONCENTRATED. The cells lose water and shrinkThe intracellular fluid becomes more concentrated.Water and ions move freely from the plasma into the interstitial fluid and the interstitial fluid becomes more concentrated. The increased osmotic potential draws water out of the cells.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      0
      Seconds

  • Question 21 - Regarding anaemia, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Anaemia is usually associated with a decrease in red cell 2,3 - DPG.

      Explanation:

      Anaemia is defined as a reduction in haemoglobin concentration below the normal range for the age and sex of the individual. Children tend to have lower haemoglobin than adults, and women tend to have lower haemoglobin than men. Anaemia may occur from an actual reduction in total circulating haemoglobin mass, or with an increase in plasma volume e.g. in pregnancy, causing a dilutional anaemia. After acute major blood loss, anaemia is not immediately apparent because total blood volume is reduced and it takes up to a day for plasma volume to be replaced and hence the degree of anaemia to become apparent. The initial clinical features in acute haemorrhage are therefore a result of reduction in blood volume rather than that of anaemia. When anaemia develops slowly, the associated symptoms are often very mild as the body has time to adapt to the fall in haemoglobin. This involves mechanisms such as an increase in red cell 2,3 -diphosphoglycerate (2,3 – DPG), which shifts the oxygen dissociation curve to the right, allowing enhanced delivery of O2 to the tissues, and an increase in stroke volume and heart rate.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 22 - Which of the following statements about propofol is TRUE: ...

    Incorrect

    • Which of the following statements about propofol is TRUE:

      Your Answer:

      Correct Answer: Propofol has some antiemetic action.

      Explanation:

      Propofol has some antiemetic properties. It’s for this reason that it’s used to treat postoperative nausea and vomiting. Propofol is mostly processed in the liver, with the kidneys excreting just around 1% of it unaltered. Propofol, unlike thiopental, does not produce tissue necrosis when it is extravasated. Propofol lowers intracranial pressure via lowering brain metabolic rate and cerebral blood flow. Propofol is thought to be safe for people with bronchial asthma and chronic obstructive pulmonary disease.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
      Seconds

  • Question 23 - You are planning on starting antibiotic therapy for a patient with a diagnosis...

    Incorrect

    • You are planning on starting antibiotic therapy for a patient with a diagnosis of gonorrhoea.Which of these is the MOST appropriate antibiotic combination?

      Your Answer:

      Correct Answer: Ceftriaxone and azithromycin

      Explanation:

      Currently, ceftriaxone in combination with azithromycin or doxycycline is the combination of antibiotics used in the treatment of gonorrhoea.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 24 - Regarding aspirin at analgesic doses, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding aspirin at analgesic doses, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: It is contraindicated in patients with severe heart failure.

      Explanation:

      Aspirin (at analgesic doses) is contraindicated in severe heart failure. Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes resulting in decreased production of prostaglandins (which can lead to irritation of the gastric mucosa). The analgesic dose is greater than the antiplatelet dose, and taken orally it has a duration of action of about 4 hours. Clinical features of salicylate toxicity in overdose include hyperventilation, tinnitus, deafness, vasodilatation, and sweating.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 25 - A 25-year-old female arrives at the emergency room with a severe case of asthma....

    Incorrect

    • A 25-year-old female arrives at the emergency room with a severe case of asthma. When she doesn't seem to be improving after initial treatment, you decide to start an aminophylline infusion.From the options below, which is Aminophylline's main mechanism of action? 

      Your Answer:

      Correct Answer: Phosphodiesterase inhibition

      Explanation:

      Theophylline and Ethylenediamine are combined in a 2:1 ratio to form Aminophylline. Its solubility is improved by the addition of Ethylenediamine. It has a lower potency and a shorter duration of action than Theophylline.It is used to treat the following conditions: Heart failureIt is used to treat the following conditions: COPDBradycardiasAminophylline has the following properties:Phosphodiesterase inhibitor that increases intracellular cAMP and relaxes smooth muscle in the bronchial airways and pulmonary blood vessels.Mast cell stabilization is achieved by using a non-selective adenosine receptor antagonist.It has slight positive inotropic and chronotropic effects, increasing cardiac output and decreasing systemic vascular resistance, lowering arterial blood pressure. It has been used historically in the treatment of refractory heart failure and is indicated by the current ALS guidelines as a substitute treatment for bradycardia. The daily oral dose for adults is 900 mg, divided into 2-3 doses. For severe asthma or COPD, a loading dosage of 5 mg/kg over 10-20 minutes is given, followed by a continuous infusion of 0.5 mg/kg/hour. The therapeutic range is small (10-20 microgram/ml), hence assessments of aminophylline plasma concentrations are useful during long-term treatment.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds

  • Question 26 - A 70-year-old man has severe diarrhoea one week after taking co-amoxiclav for a...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds

  • Question 27 - Regarding Gaussian sample distribution, which of the following statements is false? ...

    Incorrect

    • Regarding Gaussian sample distribution, which of the following statements is false?

      Your Answer:

      Correct Answer: It can be skewed left or right

      Explanation:

      Gaussian distribution, also known as normal distribution, is the most important probability distribution in statistics because it fits many natural phenomena. The normal distribution is a probability function that describes how the values of a variable are distributed. Below are its characteristics:(1) Bell-shaped and symmetrical about the mean(2) The mean, median, mode are all equal(3) The total area under the curve and above the x-axis is equal to 1(4) It has long tapering tails extending infinitely but never touching the x-axis(5) It is determined by its parameters: its mean and standard deviation(6) The standard deviation becomes a more meaningful quality than merely being a measure of dispersionThe mean is the most common measure of central tendency. It is the sum of all observed values divided by the number of observation, and is also known as the ‘average’.The median is the value that falls in the middle position when the observations are ranked in order from the smallest to the largest. If the number of observations is odd, the median is the middle number. If it is even, the median is the average of the two middle numbers.The mode is the value that occurs with the greatest frequency in a set of observations, and is commonly used in public health statistics, such as the top 10 causes of mortality.

    • This question is part of the following fields:

      • Evidence Based Medicine
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      Seconds

  • Question 28 - A foot drop is a sign of damage to which of the following...

    Incorrect

    • A foot drop is a sign of damage to which of the following nerves?

      Your Answer:

      Correct Answer: Deep fibular nerve

      Explanation:

      The deep fibular nerve was previously referred to as the anterior tibial nerve. It starts at the common fibular nerve bifurcation, between the fibula and the proximal part of the fibularis longus. Damage to this nerve can cause foot drop or loss of dorsiflexion since this nerve controls the anterior leg muscles.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 29 - After collapsing in his nursing home, a 70-year-old man is brought into the...

    Incorrect

    • After collapsing in his nursing home, a 70-year-old man is brought into the ER. He has diabetes mellitus and is on medication for it. An RBS of 2.0 mmol/L (3.9-5.5 mmol/L) is recorded in the ER. Out of the following, which medication for diabetes mellitus is LEAST likely responsible for his hypoglycaemic episode?

      Your Answer:

      Correct Answer: Metformin

      Explanation:

      Metformin is a biguanide used as the first-line to treat type 2 diabetes mellitus. It has a good reputation as it has an extremely low risk of causing hypoglycaemia compared to the other agents for diabetes. It does not affect the insulin secreted by the pancreas or increase insulin levels. Toxicity with metformin can, however, cause lactic acidosis with associated hypoglycaemia.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 30 - Regarding V/Q mismatch, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding V/Q mismatch, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: In a true shunt, increasing inspired oxygen has no effect on improving hypoxaemia.

      Explanation:

      Both ventilation and perfusion increase towards the lung base, because of the effects of gravity, but the gravitational effects are greater on perfusion than ventilation and therefore there is a regional variation in V/Q ratio from lung apex (high V/Q) to lung base (low V/Q). In a pure shunt, there is normal perfusion but absent ventilation and the V/Q ratio = 0. In a true shunt increasing oxygen fraction has no effect because the oxygen-enriched air fails to reach the shunted blood. An increased A-a gradient is seen in V/Q mismatch.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
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