-
Question 1
Correct
-
Question 2
Correct
-
On her most recent blood tests, a 55 year-old female with a history of hypertension was discovered to be hypokalaemic. She is diagnosed with primary hyperaldosteronism.Which of the following is a direct action of aldosterone?
Your Answer: Secretion of H + into the distal convoluted tubule
Explanation:Aldosterone is a steroid hormone produced in the adrenal cortex’s zona glomerulosa. It is the most important mineralocorticoid hormone in the control of blood pressure. It does so primarily by promoting the synthesis of Na+/K+ATPases and the insertion of more Na+/K+ATPases into the basolateral membrane of the nephron’s distal tubules and collecting ducts, as well as stimulating apical sodium and potassium channel activity, resulting in increased sodium reabsorption and potassium secretion. This results in sodium conservation, potassium secretion, water retention, and a rise in blood volume and blood pressure.Aldosterone is produced in response to the following stimuli:Angiotensin II levels have risen.Potassium levels have increased.ACTH levels have risen.Aldosterone’s principal actions are as follows:Na+ reabsorption from the convoluted tubule’s distal endWater resorption from the distal convoluted tubule (followed by Na+)Cl is reabsorbed from the distal convoluted tubule.K+ secretion into the convoluted distal tubule’s H+ secretion into the convoluted distal tubule’s
-
This question is part of the following fields:
- Physiology
- Renal Physiology
-
-
Question 3
Correct
-
In a patient with an ongoing seizure, after what time period should treatment be commenced?
Your Answer: 5 minutes
Explanation:Immediate emergency care and treatment should be given to children, young people and adults who have prolonged or repeated convulsive seizures.Prolonged seizures last 5 minutes or more. Repeated seizures refer to 3 or more seizures in an hour.
-
This question is part of the following fields:
- Central Nervous System
- Pharmacology
-
-
Question 4
Correct
-
A 27-year-old man has been diagnosed with testicular cancer and has spread to the regional lymph nodes. The lymph from the testes will drain to which of the following nodes?
Your Answer: Para-aortic lymph nodes
Explanation:Testes are retroperitoneal organs and its lymphatic drainage is to the lumbar and para-aortic nodes along the lumbar vertebrae.The scrotum is the one which drains into the nearby superficial inguinal nodes.The glans penis and clitoris drains into the deep inguinal lymph nodes.
-
This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
-
-
Question 5
Correct
-
Regarding the phases of gastric secretion, which of the following statements is INCORRECT:
Your Answer: A high pH in the stomach inhibits gastrin secretion.
Explanation:A low pH in the stomach inhibits gastrin secretion, therefore when the stomach is empty or when acid has been secreted for some time after food has entered it, there is inhibition of acid secretion. However, when food first enters the stomach, the pH rises, and this leads to release of the inhibition and causes a maximum secretion of gastrin. Thus gastric acid secretion is self-regulating.
-
This question is part of the following fields:
- Gastrointestinal
- Physiology
-
-
Question 6
Correct
-
Antispasmodic drugs are primarily indicated in which of the following conditions:
Your Answer: Irritable bowel syndrome
Explanation:Antispasmodics, such as antimuscarinics, may be used in the management of irritable bowel syndrome. Other antispasmodics used include direct-acting smooth muscle relaxants such as mebeverine, alverine, and peppermint oil. Antispasmodics are contraindicated in bowel obstruction and severe inflammatory bowel disease. Antispasmodics are occasionally of value in treating abdominal cramp associated with diarrhoea but they should not be used for primary treatment. Antispasmodics should be avoided in young children with gastroenteritis because they are rarely effective and have troublesome side effects. Antimuscarinics are contraindicated in urinary retention.
-
This question is part of the following fields:
- Gastrointestinal
- Pharmacology
-
-
Question 7
Correct
-
Elevation of the mandible is produced primarily by which of the following muscles:
Your Answer: Temporalis, masseter and medial pterygoid
Explanation:Elevation of the mandible is generated by the temporalis, masseter and medial pterygoid muscles.
-
This question is part of the following fields:
- Anatomy
- Head And Neck
-
-
Question 8
Correct
-
Regarding codeine, which of the following statements is INCORRECT:
Your Answer: There is a reduced risk of toxicity in patients who are ultra-rapid metabolisers of codeine.
Explanation:Codeine phosphate is a weak opioid and can be used for the relief of mild to moderate pain where other painkillers such as paracetamol or ibuprofen have proved ineffective.Codeine is metabolised to morphine which is responsible for its therapeutic effects. Codeine 240 mg is approximately equivalent to 30 mg of morphine. The capacity to metabolise codeine can vary considerably between individuals; there is a marked increase in morphine toxicity in people who are ultra rapid metabolisers, and reduced therapeutic effect in poor codeine metabolisers. Codeine is contraindicated in patients of any age who are known to be ultra-rapid metabolisers of codeine (CYP2D6 ultra-rapid metabolisers).Codeine is also contraindicated in children under 12, and in children of any age who undergo the removal of tonsils or adenoids for the treatment of obstructive sleep apnoea due to reports of morphine toxicity.
-
This question is part of the following fields:
- Central Nervous System
- Pharmacology
-
-
Question 9
Correct
-
A 49-year-old woman with haemoglobin of 6 g/dL following persistent vaginal bleeding receives blood transfusion. She developed pain and burning at her cannula site and complains of a feeling of “impending doom”, nausea, and severe back pain shortly after transfusion was started. Her temperature is 38.9ºC.What is the most appropriate treatment?
Your Answer: Stop the transfusion and administer IV fluids
Explanation:Acute haemolytic transfusion reactions present with: Feeling of ‘impending doom’ as the earliest symptom, fever and chills, pain and warmth at transfusion site, nausea and vomiting, back, joint, and chest pain. Transfusion should be stopped immediately and IV fluid (usually normal saline) administered.Supportive measures and paracetamol can be given since patient has fever but it is not the immediate first step.
-
This question is part of the following fields:
- Haematology
- Pathology
-
-
Question 10
Correct
-
Which of the following is NOT an advantage of a cohort study used to investigate the relationship between exposure to a risk factor and a future outcome:
Your Answer: Particularly suitable for rare diseases
Explanation:Advantages: ideal for studying associations between an exposure and an outcome when the exposure is uncommon, the time sequence of events can be assessed, they can provide information on a wide range of disease outcomes, the absolute and relative risk of disease can be measured directly, they can give a direct estimation of disease incidence ratesDisadvantages: costly and can take long periods of time if the outcome is delayed, subject to subject-selection and loss to follow-up bias, large sample size required for rare outcome of interest so it is not useful for rare diseases, prone to confounding
-
This question is part of the following fields:
- Evidence Based Medicine
- Study Methodology
-
-
Question 11
Correct
-
Regarding haemophilia A, which of the following statements is INCORRECT:
Your Answer: In haemophilia both the APTT and PT are prolonged.
Explanation:Haemophilia A is the most common of the hereditary clotting factor deficiencies. The inheritance is sex-linked but up to one-third of patients have no family history and these cases result from recent mutation. The vast majority of cases are inherited in an X-linked recessive fashion, affecting males born to carrier mothers. Females born to affected fathers can also, rarely, be affected due to homozygosity for the gene, where there is marriage to close relatives. The defect is an absence or low level of plasma factor VIII. The APTT is prolonged but the PT is normal. Recurrent painful haemarthroses and muscle haematomas dominate the clinical course of severely affected patients and if inadequately treated, lead to progressive joint deformity and disability. Local pressure can cause entrapment neuropathy or ischaemic necrosis. Prolonged bleeding occurs after dental extractions or post-trauma. Spontaneous haematuria and gastrointestinal haemorrhage may occur. The clinical severity of the disease correlates inversely with the factor VIII level. Operative and post-traumatic haemorrhage are life-threatening both in severely and mildly affected patients.
-
This question is part of the following fields:
- Haematology
- Pathology
-
-
Question 12
Correct
-
Which of the following is a clinical effect of hyperkalaemia:
Your Answer: Muscle weakness
Explanation:Clinical features of hyperkalaemia may include: paraesthesia, muscle weakness or paralysis, cardiac conduction abnormalities and dysrhythmias. Clinical features of hypokalaemia may include: muscle weakness, muscle cramps, rhabdomyolysis and myoglobinuria, ascending paralysis resulting in respiratory failure, constipation, gut ileus with distension, anorexia, nausea and vomiting, impaired ADH action with polyuria and polydipsia, ECG changes and cardiac arrhythmias.
-
This question is part of the following fields:
- Physiology
- Renal
-
-
Question 13
Correct
-
A 39-year-old woman's son with meningococcal meningitis was recently admitted to the Paediatric Intensive Care Unit. She is currently 22 weeks pregnant and is concerned about the possibility of her also contracting the disease as she cared closely for her son during his admission. Which antibiotic would be the MOST appropriate choice for chemoprophylaxis in this case?
Your Answer: Ciprofloxacin
Explanation:Ciprofloxacin is recommended for use as meningococcal chemoprophylaxis in all age groups and in pregnancy, and is the most appropriate for this patient.However, rifampicin is the drug of choice for meningococcal chemoprophylaxis because it is licensed for chemoprophylaxis, but multiple doses are necessary and it is not readily available in community pharmacies. It also interacts with oral contraceptives.
-
This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
-
-
Question 14
Correct
-
Which of the following is NOT a typical feature of a lesion to the vestibulocochlear nerve:
Your Answer: Hyperacusis
Explanation:Hyperacusis is increased acuity of hearing with hypersensitivity to low tones resulting from paralysis of the stapedius muscle, innervated by the facial nerve. General sensation to the face and to the anterior two-thirds of the tongue is carried by the divisions of the trigeminal nerve (although taste to the anterior two-thirds of the tongue is supplied by the facial nerve). Eye movements are mediated by the oculomotor, trochlear and abducens nerve. Ptosis results from paralysis of the levator palpebrae superioris, innervated by the oculomotor nerve, or the superior tarsal muscle, innervated by the sympathetic chain.
-
This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
-
-
Question 15
Correct
-
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 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
-
-
Question 16
Correct
-
Question 17
Correct
-
Which of the following ions is more abundant in extracellular fluid than in intracellular fluid:
Your Answer: Cl -
Explanation:Protein and phosphate are the primary intracellular anions, while chloride (Cl-) and bicarbonate are the predominant extracellular anions (HCO3-).
-
This question is part of the following fields:
- Basic Cellular
- Physiology
-
-
Question 18
Correct
-
Carbon dioxide is transported in the blood approximately:
Your Answer: 60% as bicarbonate ions, 30% as carbamino compounds and 10% dissolved in plasma.
Explanation:Carbon dioxide is transported in the blood from tissues to the lungs in three ways as bicarbonate ions (60%), as carbamino compounds with proteins (30%) or simply dissolved in plasma (10%).
-
This question is part of the following fields:
- Physiology
- Respiratory
-
-
Question 19
Correct
-
A 26-year-old man is involved in a motorcycle accident that results in an open fracture of his tibia and fibula. The nerve that innervates peroneus tertius is damaged as a consequence of his injuries.Peroneus tertius receives its innervation from which of the following nerves? Select ONE answer only.
Your Answer: Deep peroneal nerve
Explanation:Peroneus brevis is innervated by the superficial peroneal nerve.Peroneus longus is innervated by the superficial peroneal nerve.Peroneus tertius is innervated by the deep peroneal nerve.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 20
Correct
-
Regarding diuretics, which of the following statements is CORRECT:
Your Answer: Carbonic anhydrase inhibitors have their effect by inhibiting bicarbonate reabsorption.
Explanation:Carbonic anhydrase inhibitors e.g. acetazolamide block the reaction of carbon dioxide and water and so prevent Na+/H+exchange and bicarbonate reabsorption. The increased bicarbonate levels in the filtrate oppose water reabsorption. Proximal tubule sodium reabsorption is also reduced because it is partly dependent on bicarbonate reabsorption.
-
This question is part of the following fields:
- Physiology
- Renal
-
SESSION STATS - PERFORMANCE PER SPECIALTY
