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  • Question 1 - Regarding ciprofloxacin, which of the following statements is INCORRECT: ...

    Correct

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

      Your Answer: Ciprofloxacin decreases plasma concentrations of theophylline.

      Explanation:

      Ciprofloxacin increases plasma concentrations of theophylline. There is an increased risk of convulsions when quinolones are given with NSAIDs or theophylline. There is an increased risk of tendon damage when quinolones are given with corticosteroids. Quinolones are known to increase the QT-interval and should not be taken with concomitantly with other drugs that are known to cause QT-interval prolongation. There is an increased risk of myopathy when erythromycin or clarithromycin are taken with simvastatin or atorvastatin.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      46.8
      Seconds
  • Question 2 - A newborn baby is rushed to the neonatal ICU 4 hours after birth...

    Incorrect

    • A newborn baby is rushed to the neonatal ICU 4 hours after birth due to sudden onset severe jaundice and generalised oedema. Family history reveals that this is the second baby, while blood testing shows that the mother has an Rh-negative blood group while the baby is Rh-positive. A diagnosis of haemolytic disease of the newborn is established. Which one of the following hypersensitivity reactions have occurred in this case?

      Your Answer: Type I hypersensitivity reaction

      Correct Answer: Type II hypersensitivity reaction

      Explanation:

      Hepatitis A usually doesn’t pose a special risk to a pregnant woman or her baby. Maternal infection doesn’t result in birth defects, and a mother typically doesn’t transmit the infection to her baby. HAV is almost always transmitted by the faecal-oral route and is usually acquired through close personal contact or via contaminated food.When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes scars, defects of muscle and bone, malformed and paralyzed limbs, small head size, blindness, seizures, and intellectual disability.TORCH Syndrome refers to infection of a developing foetus or newborn by any of a group of infectious agents. “TORCH” is an acronym meaning (T)oxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex.Infection with any of these agents may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and other symptoms and findings.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      96.8
      Seconds
  • Question 3 - A 4-year old boy is taken to the emergency room after a sudden...

    Incorrect

    • A 4-year old boy is taken to the emergency room after a sudden onset of coughing and wheezing. Further investigation reveals that he was drawing quietly in his room, when suddenly, he became anxious and started coughing. The parents also noted that the eraser on top of the pencil was missing.A plain radiographic chest imaging is conducted, and confirmed foreign body aspiration.Which of the following areas in the tracheobronchial tree is the most probable location of the aspirated eraser?

      Your Answer:

      Correct Answer: Right main bronchus

      Explanation:

      In foreign body aspiration, the foreign body is more likely to enter the right main bronchus because it is shorter, wider and more vertical than the left main bronchus. In a patient who is standing or sitting, the foreign body tends to become lodged in the posterobasal segment of the inferior lobe of the right lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 4 - A patient is referred for lung function tests on account of a history...

    Incorrect

    • A patient is referred for lung function tests on account of a history of breathlessness and cough.Which statement about lung volumes is correct?

      Your Answer:

      Correct Answer: The tidal volume is the volume of air drawn in and out of the lungs during normal breathing

      Explanation:

      The tidal volume(TV) is the amount of air that moves in and out of the lungs with each respiratory cycle. In a healthy male, the usual volume is 0.5 L (,7 ml/kg body mass).The vital capacity(VC) is the maximum amount of air that can be exhaled following maximal inspiration. The usual volume in a healthy male is 4.5 L.The residual volume(RV) is the amount of air remaining in the lungs after maximum expiration. The usual volume in a healthy male is 1.0 L.The inspiratory reserve volume(IRV) is the maximum amount of air that can be breathed in forcibly after normal inspiration. The usual volume in a healthy male is 3.0 L.The expiratory reserve volume(ERV) is the volume of air that can be breathed out forcibly after normal expiration. The usual volume in a healthy male is 1.0 L.Total lung capacity(TLC) is the volume of air the lungs can accommodate. TLC = RV+VC. The usual volume in a healthy male is 5.5 L.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
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  • Question 5 - Which of the following immunoglobulin molecules is the most abundant in secretions (such...

    Incorrect

    • Which of the following immunoglobulin molecules is the most abundant in secretions (such as saliva and breast milk):

      Your Answer:

      Correct Answer: IgA

      Explanation:

      IgA is the predominant antibody class in secretions and tremendous quantities are secreted into various body spaces and onto mucosal surfaces (the gut lumen, the pharynx and sinuses, the larger airways, although not the alveoli). Because of its size, the majority of IgM is found in the circulation.Along with IgM, IgD is predominant among the surface receptors of mature B cells, where it plays a key role in B cells activation.IgE has the lowest concentration in normal human serum. It plays a prominent role in immune responses to helminth parasites, and in allergic reactions.IgG is the most abundant immunoglobulin and constitutes 75 percent of serum immunoglobulin in an adult human

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
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  • Question 6 - The enzyme protein gastric lipase is responsible for the breakdown of lipids in...

    Incorrect

    • The enzyme protein gastric lipase is responsible for the breakdown of lipids in the stomach.Which of the following cell types secretes gastric lipase? 

      Your Answer:

      Correct Answer: Chief cells

      Explanation:

      Gastric lipase, commonly known as LIPF, is an acidic lipase released by gastric chief cells, which are found deep within the stomach lining’s mucosal layer. It’s an enzymatic protein that’s in charge of fat digestion in the stomach.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
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  • Question 7 - A 28-year-old female arrives after taking an unknown chemical in excess. She is tired...

    Incorrect

    • A 28-year-old female arrives after taking an unknown chemical in excess. She is tired and her speech is slurred. The following are her observations and results: HR 118, BP 92/58, SaO2 96%HR 118,  11/15  The following are the results  of his arterial blood gas (ABG):pH: 7.24 pO 2 : 9.4 kPa PCO2 : 3.3 kPa HCO 3 -: 22 mmol/l Na + : 143 mmol/l Cl – : 99 mmol/l Lactate: 5 IU/lWhich of the following statements about this patient is TRUE?

      Your Answer:

      Correct Answer: Her anion gap is elevated

      Explanation:

      The interpretation of arterial blood gas (ABG) aids in the measurement of a patient’s pulmonary gas exchange and acid-base balance. The normal values on an ABG vary a little depending on the analyser, but they are roughly as follows:Variable RangepH 7.35 – 7.45PaO2 10 – 14 kPaPaCO2 4.5 – 6 kPaHCO3- 22 – 26 mmol/lBase excess -2 – 2 mmol/lThe patient’s history indicates that she has taken an overdose in this case. Because her GCS is 11/15 and she can communicate with slurred speech, she is clearly managing her own airway, there is no current justification for intubation.The following are the relevant ABG findings:Hypoxia (mild)pH has been lowered (acidaemia)PCO2 levels are low.bicarbonate in its natural stateLactate levels have increasedThe anion gap represents the concentration of all the unmeasured anions in the plasma. It is the difference between the primary measured cations and the primary measured anions in the serum. It can be calculated using the following formula:Anion gap = [Na+] – [Cl-] – [HCO3-]The reference range varies depending on the technique of measurement, but it is usually between 8 and 16 mmol/L.The following formula can be used to compute her anion gap:Anion gap = [143] – [99] – [22]Anion gap = 22As a result, it is clear that she has a metabolic acidosis with an increased anion gap.The following are some of the causes of type A and type B lactic acidosis:Type A lactic acidosisType B lactic acidosisShock (including septic shock)Left ventricular failureSevere anaemiaAsphyxiaCardiac arrestCO poisoningRespiratory failureSevere asthma and COPDRegional hypoperfusionRenal failureLiver failureSepsis (non-hypoxic sepsis)Thiamine deficiencyAlcoholic ketoacidosisDiabetic ketoacidosisCyanide poisoningMethanol poisoningBiguanide poisoning

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
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  • Question 8 - On his stool culture, a patient with a diarrhoeal illness grows Escherichia coli.What...

    Incorrect

    • On his stool culture, a patient with a diarrhoeal illness grows Escherichia coli.What SINGLE statement about Escherichia coli is true?

      Your Answer:

      Correct Answer: Most serotypes are harmless

      Explanation:

      Escherichia coli is a Gram-negative, non-spore forming, facultative anaerobic, rod-shaped bacterium. Although some can cause serious food poisoning, most serotypes are harmless.Escherichia coli is transmitted via the faeco-oral route.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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  • Question 9 - Which law describes the rate of diffusion in a solution? ...

    Incorrect

    • Which law describes the rate of diffusion in a solution?

      Your Answer:

      Correct Answer: Fick’s law

      Explanation:

      Fick’s law describes the rate of diffusion in a solution. Fick’s law states that:Jx = -D A (ΔC / Δx)Where:Jx = The amount of substance transferred per unit timeD = Diffusion coefficient of that particular substanceA = Surface area over which diffusion occursΔC = Concentration difference across the membraneΔx = Distance over which diffusion occursThe negative sign reflects movement down the concentration gradient

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
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  • Question 10 - Which of the following serology results is consistent with chronic hepatitis B infection:...

    Incorrect

    • Which of the following serology results is consistent with chronic hepatitis B infection:

      Your Answer:

      Correct Answer: HBsAg positive and anti-HBc IgG positive

      Explanation:

      Disease state vs SerologyAcute hepatitis: BHBsAg, HBeAg, anti-HBc IgMChronic hepatitis B (low infectivity): HBsAg (>6/12), anti-HBe, anti-HBc IgGChronic hepatitis B (high infectivity): HBsAg (>6/12), HBeAg, anti-HBc IgGCleared infection: Anti-HBs, anti-HBe, anti-HBc IgGVaccinated: Anti-HBs

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 11 - A 30-year-old man bought into the ED with increased thirst, confusion, abdominal pain...

    Incorrect

    • A 30-year-old man bought into the ED with increased thirst, confusion, abdominal pain and constipation is suspected to have hypercalcaemia.What is the commonest cause of hypercalcaemia in the UK?

      Your Answer:

      Correct Answer: Primary hyperparathyroidism

      Explanation:

      The commonest cause of hypercalcaemia in the UK is primary hyperparathyroidism, which accounts for around 70-80% of cases. It is commoner in younger patients and in community setting.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
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  • Question 12 - Which ONE statement about homeostasis is true? ...

    Incorrect

    • Which ONE statement about homeostasis is true?

      Your Answer:

      Correct Answer: Negative feedback occurs via receptors, comparators and effectors

      Explanation:

      Homeostasis is the property of a system in which variables are regulated so that internal conditions remain relatively constant and stable. Homeostasis is achieved by a negative feedback mechanism.Negative feedback occurs based upon a set point through receptors, comparators and effectors. The ‘set point’ is a NARROW range of values within which normal function occurs.The two body systems that regulate homeostasis are the Nervous system and the Endocrine system. The smooth muscle of the uterus becomes more active towards the end of pregnancy. This is a POSITIVE feedback.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
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  • Question 13 - You proceed to administer lorazepam intravenously to a 21-year-old patient with status epilepticus....

    Incorrect

    • You proceed to administer lorazepam intravenously to a 21-year-old patient with status epilepticus. Which of the following best describes lorazepam's action?

      Your Answer:

      Correct Answer: Potentiates effect of GABA

      Explanation:

      Lorazepam is a type of benzodiazepine. Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists with sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant characteristics that promote inhibitory synaptic transmission across the central nervous system.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 14 - A 30-year-old patient has a mild exacerbation of his asthma. His steroid inhaler...

    Incorrect

    • A 30-year-old patient has a mild exacerbation of his asthma. His steroid inhaler ran out a couple of weeks ago, and he has not replaced it.Which of these statements describes the mechanism of action of corticosteroids in asthma?

      Your Answer:

      Correct Answer: Reduction of bronchial inflammation

      Explanation:

      Inhaled corticosteroids suppresses airway inflammation seen in asthma by downregulating pro-inflammatory proteins.They also appear to reverse components of asthma-induced structural changes (airway remodelling), including increased vascularity of the bronchial wall.Corticosteroids reduces the number of inflammatory cells (eosinophils, T lymphocytes, mast cells, and dendritic cells) in the airways.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
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  • Question 15 - Which of the following pathogens is the common cause of diarrhoea in a...

    Incorrect

    • Which of the following pathogens is the common cause of diarrhoea in a patient who has had a prolonged course of a broad spectrum of antibiotics?

      Your Answer:

      Correct Answer: Clostridium difficile

      Explanation:

      Clostridium difficile is the most likely cause of diarrhoea after a long course of broad-spectrum antibiotic treatment. Clostridium difficile-associated diarrhoea appeared to be linked to an increase in the usage of third-generation cephalosporins.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 16 - Which of the following clinical features is most suggestive of a lesion of...

    Incorrect

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

      Your Answer:

      Correct Answer: Receptive dysphasia

      Explanation:

      Damage to the Wernicke’s speech area in the temporal lobe can result in a receptive dysphasia. Hemispatial neglect is most likely to occur in a lesion of the parietal lobe. Homonymous hemianopia is most likely to occur in a lesion of the occipital lobe. Expressive dysphasia is most likely to occur in a lesion of the Broca speech area in the frontal lobe. Conjugate eye deviation towards the side of the lesion is most likely to occur in a lesion of the frontal lobe.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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  • Question 17 - A 40-year-old man who has a history of asthma arrives at the emergency...

    Incorrect

    • A 40-year-old man who has a history of asthma arrives at the emergency department complaining of palpitations that have been going on for 5 days. Which of the following beta-blockers is the safest for an asthmatic patient?

      Your Answer:

      Correct Answer: Atenolol

      Explanation:

      Atenolol is a beta blocker, which is a type of medication that works by preventing certain natural substances in the body, such as epinephrine, from acting on the heart and blood vessels. This effect reduces heart rate, blood pressure, and cardiac strain. Atenolol, bisoprolol fumarate, metoprolol tartrate, nebivolol, and (to a lesser extent) acebutolol have a lower action on beta2 (bronchial) receptors and are thus cardio selective but not cardiac specific. They have a lower effect on airway resistance, although they are not without this adverse effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 18 - You are teaching a group of medical students about cardiovascular examination. You are...

    Incorrect

    • You are teaching a group of medical students about cardiovascular examination. You are discussing heart sounds and the cardiac cycle. Which of the following stages of the cardiac cycle occurs immediately after the aortic valve closes:

      Your Answer:

      Correct Answer: Isovolumetric relaxation

      Explanation:

      Immediately after the closure of the semilunar valves, the ventricles rapidly relax and ventricular pressure decreases rapidly but the AV valves remain closed as initially the ventricular pressure is still greater than atrial pressure. This is isovolumetric relaxation. Atrial pressure continues to rise because of venous return, with the v wave of the JVP waveform peaking during this phase. Rapid flow of blood from the atria into the ventricles during the ventricular filling phase causes thethird heart sound, which is normal in children but, in adults, is associated with disease such as ventricular dilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 19 - What is the primary mode of action of Enoxaparin? ...

    Incorrect

    • What is the primary mode of action of Enoxaparin?

      Your Answer:

      Correct Answer: Inhibits factor Xa

      Explanation:

      Heparin acts as an anticoagulant by enhancing the inhibition rate of clotting proteases by antithrombin III impairing normal haemostasis and inhibition of factor Xa. Low molecular weight heparins have a small effect on the activated partial thromboplastin time and strongly inhibit factor Xa. Enoxaparin is derived from porcine heparin that undergoes benzylation followed by alkaline depolymerization.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 20 - A GP is considering prescribing a non-steroidal anti-inflammatory (NSAID) for pain relief for...

    Incorrect

    • A GP is considering prescribing a non-steroidal anti-inflammatory (NSAID) for pain relief for a patient with a knee injuryWhich of these statements about NSAIDs is NOT true?

      Your Answer:

      Correct Answer: Side effects are less commonly seen with indomethacin than naproxen

      Explanation:

      Most NSAIDs act as non-selective inhibitors of the enzyme cyclo-oxygenase (COX). They inhibit both COX-1 and COX-2 isoenzymes. Only about 60% of patients will respond to any given NSAID.It can take 21 days of treatment for a clinically appreciable reduction in inflammation to be apparent. If no improvement is seen after 21 days, the NSAID should be changed.The use of NSAIDs in the 3rd trimester of pregnancy is associated with the following risks: delayed onset of labour, premature closure of ductus arteriosus and foetal kernicterus.Side effects are lowest in Ibuprofen and highest in indomethacin. so side effects are more commonly seen with indomethacin than naproxen.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
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  • Question 21 - After collapsing at home, a 75-year-old man is transported in an ambulance. He...

    Incorrect

    • After collapsing at home, a 75-year-old man is transported in an ambulance. He is now awake, but he is experiencing palpitations and chest pain. He is transported to resuscitation and placed on a cardiac monitor, which indicates that he is in VT. An amiodarone infusion is set up.Which of the following statements about amiodarone side effects is correct?

      Your Answer:

      Correct Answer: It can cause jaundice

      Explanation:

      Amiodarone has a lot of potential toxic side effects, so it’s important to get a full clinical evaluation before starting treatment with it.The following are some of the most common amiodarone side effects:ArrhythmiasCorneal microdepositsHepatic disordersHyperthyroidismHypothyroidismHepatic disorders and jaundiceNauseaPeripheral neuropathyRespiratory disorders (including lung fibrosis)Sleep disturbanceSkin reactionsQT prolongationAmiodarone can cause optic neuritis, which is a very rare side effect. If this happens, the amiodarone should be stopped right away because it poses a risk of blindness.Most people who take amiodarone develop corneal microdeposits, which go away once the medication is stopped and rarely cause vision problems.Amiodarone has a chemical structure that is similar to that of thyroxine and can bind to the nuclear thyroid receptor. It can cause both hypothyroidism and hyperthyroidism, though hypothyroidism is far more common, with 5-10% of patients suffering from it.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 22 - Which of the following statements concerning hepatitis D is TRUE: ...

    Incorrect

    • Which of the following statements concerning hepatitis D is TRUE:

      Your Answer:

      Correct Answer: It can only be transmitted with, or to somebody who is infected with, Hepatitis B.

      Explanation:

      Hepatitis D virus (HDV) is an RNA virus that was discovered in 1977 and is structurally unrelated to the hepatitis A (HAV), hepatitis B (HBV), and hepatitis C (HCV) viruses. HDV causes a unique infection that requires the assistance of HBV viral particles to replicate and infect hepatocytes. Its clinical course is varied and ranges from acute, self-limited infection to acute, fulminant liver failure. Chronic liver infection can lead to end-stage liver disease and associated complications (including accelerated fibrosis, liver decompensation, and hepatocellular carcinoma).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 23 - Which of the following is NOT mainly characterised by intravascular haemolysis: ...

    Incorrect

    • Which of the following is NOT mainly characterised by intravascular haemolysis:

      Your Answer:

      Correct Answer: Beta-Thalassaemia

      Explanation:

      Causes of intravascular haemolysis:Haemolytic transfusion reactionsG6PD deficiencyRed cell fragmentation syndromesSome severe autoimmune haemolytic anaemiasSome drug-and infection-induced haemolytic anaemiasParoxysmal nocturnal haemoglobinuria

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 24 - You suspect that your patient with polycystic kidney disease has developed a berry...

    Incorrect

    • You suspect that your patient with polycystic kidney disease has developed a berry aneurysm as a complication of his disease. The patient complains of a sudden, severe headache. You are guessing subarachnoid haemorrhage secondary to a ruptured berry aneurysm as the cause of his severe headaches. What is the most likely location of his aneurysm?

      Your Answer:

      Correct Answer: Anterior communicating artery

      Explanation:

      One of the complications that polycystic kidney disease may cause is the development of a brain aneurysm. A berry aneurysm is the most common type of brain aneurysm. The Circle of Willis, where the major blood vessels meet at the base of the brain, is where it usually appears. The most common junctions of the Circle of Willis where an aneurysm may occur include the anterior communicating artery (35%), internal carotid artery (30%), the posterior communicating artery and the middle cerebral artery (22%), and finally, the posterior circulation sites, most commonly the basilar artery tip.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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  • Question 25 - Langhans giant cells, seen in granulomatous inflammation. are: ...

    Incorrect

    • Langhans giant cells, seen in granulomatous inflammation. are:

      Your Answer:

      Correct Answer: Multinucleated cells formed from fusion of epithelioid cells

      Explanation:

      A granuloma is a collection of five or more epithelioid macrophages, with or without attendant lymphocytes and fibroblasts; epithelioid macrophages are altered macrophages which have turned themselves over to becoming giant phagocytosing and killing machines, they often fuse to become multinucleate (Langhans) giant cells.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
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  • Question 26 - In adult basic life support, chest compressions should be performed at which of...

    Incorrect

    • In adult basic life support, chest compressions should be performed at which of the following rates:

      Your Answer:

      Correct Answer: 100 - 120 per minute

      Explanation:

      Chest compressions should be performed at a rate of 100 – 120 per minute.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 27 - A 55-year-old female is urgently rushed into the Emergency Department as she complains...

    Incorrect

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

      Your Answer:

      Correct Answer: It activates antithrombin III

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 28 - A 25-year-old patient requires procedural sedation for reduction of an open fracture of...

    Incorrect

    • A 25-year-old patient requires procedural sedation for reduction of an open fracture of his tibia and fibula. You plan on using ketamine as the sedative agent.Ketamine works as a result of action on what type of receptor? Select ONE answer only.

      Your Answer:

      Correct Answer: N-methyl-D-aspartate (NMDA)

      Explanation:

      Ketamine is the only anaesthetic agent available that has analgesic, hypnotic, and amnesic properties. When used correctly it is a very useful and versatile drug.Ketamine acts by non-competitive antagonism of the NMDA receptor Ca2+ channel pore and also inhibits NMDA receptor activity by interaction with the phencyclidine binding site.Ketamine can be used intravenously and intramuscularly. The intramuscular dose is 10 mg/kg, and when used by this route, it acts within 2-8 minutes and has a duration of action of 10-20 minutes. The intravenous dose is 1.5-2 mg/kg administered over a period of 60 seconds. When used intravenously, it acts within 30 seconds and has a duration of action of 5-10 minutes. Ketamine is also effective when administered orally, rectally, and nasally.Ketamine causes tachycardia, an increase in blood pressure, central venous pressure, and cardiac output, secondary to an increase in sympathetic tone. Baroreceptor function is well maintained, and arrhythmias are uncommon.The main disadvantage to the use of ketamine is the high incidence of hallucinations, nightmares, and other transient psychotic effects. These can be reduced by the co-administration of a benzodiazepine, such as diazepam or midazolam.The main side effects of ketamine are:Nausea and vomitingHypertensionNystagmusDiplopiaRash

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 29 - Regarding carbohydrate, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Most dietary carbohydrate is in the form of disaccharides.

      Explanation:

      Carbohydrates are the main energy source of most diets. They provide 17 kJ (4 kcal) of energy per gram. Most dietary carbohydrate is in the form of polysaccharides. The principal ingested polysaccharides are starch which is derived from plant sources and glycogen which is derived from animal sources. Dietary fibre consists of indigestible carbohydrate (found in plant foods) such as cellulose, lignin and pectin.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
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  • Question 30 - A patient is diagnosed as having a glucagonoma. Her blood serum glucagon concentration...

    Incorrect

    • A patient is diagnosed as having a glucagonoma. Her blood serum glucagon concentration is 1246 pg/mL.Glucagon INHIBITS which of the following processes? Select ONE answer only.

      Your Answer:

      Correct Answer: Glycolysis

      Explanation:

      Glucagon is a peptide hormone that is produced and secreted by alpha cells of the islets of Langerhans, which are located in the endocrine portion of the pancreas. The main physiological role of glucagon is to stimulate hepatic glucose output, thereby leading to increases in glycaemia. It provides the major counter-regulatory mechanism to insulin in maintaining glucose homeostasis.Hypoglycaemia is the principal stimulus for the secretion of glucagon but may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline. Glucagon then causes:GlycogenolysisGluconeogenesisLipolysis in adipose tissueThe secretion of glucagon is also stimulated by:AdrenalineCholecystokininArginineAlanineAcetylcholineThe secretion of glucagon is inhibited by:InsulinSomatostatinIncreased free fatty acidsIncreased urea productionGlycolysis is the metabolic pathway that converts glucose into pyruvate. The free energy released by this process is used to form ATP and NADH. Glycolysis is inhibited by glucagon, and glycolysis and gluconeogenesis are reciprocally regulated so that when one cell pathway is activated, the other is inactive and vice versa.Glucagon has a minor effect of enhancing lipolysis in adipose tissue. Lipolysis is the breakdown of lipids and involves the hydrolysis of triglycerides into glycerol and free fatty acids. It makes fatty acids available for oxidation.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
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