00
Correct
00
Incorrect
00 : 00 : 0 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - A 40-year-old woman presents with retrosternal central chest pain that she has been...

    Correct

    • A 40-year-old woman presents with retrosternal central chest pain that she has been complaining about for the past two days. Upon deep inspiration and while lying flat, the pain worsens but relieved by sitting forwards. The pain radiates to both of her shoulders. The result of her ECG shows widespread concave ST-elevation and PR depression. A diagnosis of pericarditis is suspected. Which of the following nerves is responsible for the pattern of her pain?

      Your Answer: Phrenic nerve

      Explanation:

      Pericarditis is inflammation of the pericardial sac and is the most common pathologic process involving the pericardium. Frequently, pericardial inflammation can be accompanied by increased fluid accumulation within the pericardial sac forming a pericardial effusion, which may be serous, hemorrhagic or purulent depending on aetiology.The classic presentation is with chest pain that is central, severe, pleuritic (worse on deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      8.8
      Seconds
  • Question 2 - Atrial natriuretic peptide (ANP) acts to cause all of the following effects EXCEPT...

    Correct

    • Atrial natriuretic peptide (ANP) acts to cause all of the following effects EXCEPT for:

      Your Answer: Vasoconstricts the afferent arteriole

      Explanation:

      ANP acts to: Inhibit Na+ reabsorption in the distal nephron (through inhibition of ENaC in principal cells)Suppress the production of reninSuppress the production of aldosteroneSuppress the production of ADHCause renal vasodilation, increasing the glomerular filtration rate

    • This question is part of the following fields:

      • Physiology
      • Renal
      4.7
      Seconds
  • Question 3 - Regarding antihistamines, which of the following statements is CORRECT: ...

    Correct

    • Regarding antihistamines, which of the following statements is CORRECT:

      Your Answer: Elderly patients and children are more susceptible to side effects.

      Explanation:

      Elderly patients and children are more susceptible to side effects. Antihistamines are competitive inhibitors at the H1-receptor. The newer antihistamines e.g. cetirizine cause less sedation and psychomotor impairment than the older antihistamines because they are much less lipid soluble and penetrate the blood brain barrier only to a slight extent. Antihistamines are used as a second line adjunct to adrenaline in anaphylaxis.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      2.8
      Seconds
  • Question 4 - A 32-year-old woman suffers a deep wound to her thigh while she was...

    Correct

    • A 32-year-old woman suffers a deep wound to her thigh while she was climbing over a barbed wire fence. As a consequence of her injury, the nerve that was severed innervates the gracilis muscle.In which of the following nerves is the gracilis muscle innervated by?

      Your Answer: Anterior branch of the obturator nerve

      Explanation:

      The gracilis muscles is innervated by the anterior branch of the obturator nerve (L2-L4).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      7.3
      Seconds
  • Question 5 - You review a 34-year-old man with lower back pain and plan to prescribe...

    Correct

    • You review a 34-year-old man with lower back pain and plan to prescribe him ibuprofen and codeine phosphate. His only past medical history of note is depression, for which he takes fluoxetine.Which of the following scenarios would prompt you to consider the co-prescription of a PPI for gastro-protection? Select ONE answer only.

      Your Answer: Co-prescription of fluoxetine

      Explanation:

      Patients at risk of gastro-intestinal ulceration (including the elderly) who need NSAID treatment should receive gastroprotective treatment. The current recommendations by NICE suggest that gastro-protection should be considered if patients have ≥1 of the following:Using maximum recommended dose of an NSAIDAged 65 or olderHistory of peptic ulcer or GI bleedingConcomitant use of medications that increase risk:Low dose aspirinAnticoagulantsCorticosteroidsAnti-depressants including SSRIs and SNRIsRequirements for prolonged NSAID usage:Patients with OA or RA at any ageLong-term back pain if older than 45It is suggested that if required, either omeprazole 20 mg daily or lansoprazole 15-30 mg daily should be the PPIs of choice.This patient is on 400 mg of ibuprofen TDS, but the maximum recommended dose of ibuprofen is 2.4 g daily. Co-prescription of codeine, raised BMI, and a family history of peptic ulceration would also not prompt gastro-protection.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      5.3
      Seconds
  • Question 6 - A new blood test is being developed to diagnose DVT. 1000 people presenting...

    Incorrect

    • A new blood test is being developed to diagnose DVT. 1000 people presenting to ED with suspected DVT undergo the new blood test and the gold standard doppler ultrasound to confirm the diagnosis. Of the 1000 people, 77 are confirmed to have a DVT. Of the patients diagnosed with DVT, 75 test positive with the new diagnostic test and of the patients not diagnosed with DVT, 125 test positive with the new diagnostic test. What is the negative predictive value of this test:DVT YesDVT NoTotalPositive testa= 75b = 125200Negative testc = 2d = 798800Total779231000

      Your Answer: 0.86

      Correct Answer: 0.99

      Explanation:

      Negative predictive value (NPV) is the proportion of individuals with a negative test result who do not have the disease.Negative predictive value (NPV) = d/(c+d) = 798/800 = 0.99 = 99%This means there is a 99% chance, if the test is negative, that the patient does not have a DVT.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      8.1
      Seconds
  • Question 7 - You've been requested to give a discussion to a group of medical students...

    Incorrect

    • You've been requested to give a discussion to a group of medical students about cardiovascular physiology. One of them inquires about cardiac output and asks if you can explain it.Which of the following statements is correct?

      Your Answer: An average resting cardiac output in a woman is 4 L/min

      Correct Answer: An average resting cardiac output in a woman is 5 L/min

      Explanation:

      The terminology cardiac output refers to the amount of blood pumped by the heart in one minute. Women’s rates are around 5 L/min, whereas men’s rates are somewhat higher, around 5.5 L/min.Cardiac output (CO) is calculated by multiplying stroke volume (SV) by heart rate (HR):CO = HR x SVAs a result, both stroke volume and heart rate are exactly proportional to cardiac output. There will be an increase in cardiac output if the stroke volume or heart rate increases, and a reduction in cardiac output if the stroke volume or heart rate lowers.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      6.6
      Seconds
  • Question 8 - You are about to perform a blood test on a patient suspected of...

    Incorrect

    • You are about to perform a blood test on a patient suspected of having systemic lupus erythematosus. Which antibodies will indicate a positive result of systemic lupus erythematosus?

      Your Answer: Rheumatoid factor

      Correct Answer: Anti-nuclear antibodies

      Explanation:

      Antinuclear antibodies (ANA) are autoantibodies to the cells’ nucleus. The ANA test is the most sensitive diagnostic test for verifying the disease’s diagnosis. Other autoantibodies that may be found in SLE patients include rheumatoid factor, antiphospholipid antibodies, and antimitochondrial antibodies.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      3.8
      Seconds
  • Question 9 - Metabolic hyperaemia harmonizes local blood flow with local O2 demand. If there is...

    Incorrect

    • Metabolic hyperaemia harmonizes local blood flow with local O2 demand. If there is an increase in metabolic rate, the production of vasoactive metabolites increases. These metabolites act locally on the surrounding arterioles, causes vasodilation and an increase blood supply.Which of these metabolites is the most potent vasodilator in skeletal muscle?

      Your Answer: Na +

      Correct Answer: K +

      Explanation:

      Hyperaemia is the process where the body adjusts blood flow to meet the metabolic needs of different tissues in health and disease. Vasoactive mediators that take part in this process include K+, adenosine, CO2, H+, phosphates and H2O2. Although the mechanism is not clear, all these mediators likely contribute to some extent at different points.Specific organs are more sensitive to specific metabolites:K+ and adenosine are the most potent vasodilators in skeletal musclesCO2 and K+ are the most potent vasodilators in cerebral circulation.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      5
      Seconds
  • Question 10 - 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: Isoniazid

      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
      6.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (2/2) 100%
Thorax (1/1) 100%
Physiology (3/3) 100%
Renal (1/1) 100%
Pharmacology (3/3) 100%
Respiratory (1/1) 100%
Lower Limb (1/1) 100%
Musculoskeletal Pharmacology (1/1) 100%
Cardiovascular Physiology (2/2) 100%
Infections (1/1) 100%
Evidence Based Medicine (1/1) 100%
Statistics (1/1) 100%
Inflammatory Responses (1/1) 100%
Pathology (1/1) 100%
Passmed