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Question 1
Correct
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Following the administration of a drug that was started a few months earlier, a patient presents with features of peripheral neuropathy.Which of the following drugs is most likely to cause peripheral neuropathy?
Your Answer: Isoniazid
Explanation:Isoniazid, a first-line agent for the treatment of tuberculosis, has the commonest side effect of peripheral neuropathy. It occurs in up to 20% of patients taking the drug at a dose > 6 mg/kg daily. Isoniazid combines with pyridoxine (vitamin B6) to form hydrazone, which is excreted in the urine. This causes a deficiency of biologically active pyridoxine leading to peripheral neuropathy.Peripheral neuropathy of isoniazid is prevented by the co-administration of pyridoxine at a dose of 10 mg for each 100 mg of isoniazid given.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 2
Incorrect
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A 26 year old male presents to emergency room with a 2 day history of burning pain when passing urine, accompanied by a green urethral discharge. Gonorrhoea is suspected. The first line antibiotic for this condition is which of the following?
Your Answer: Doxycycline
Correct Answer: Ceftriaxone
Explanation:When there is a high suspicion of gonorrhoea from clinical features, empiric treatment should be commenced whilst waiting for laboratory confirmation. The first line treatment for uncomplicated anogenital and pharyngeal disease includes ceftriaxone 500 mg IM (single dose) + azithromycin 1 g orally as a single dose. This covers concomitant chlamydia infection. For all people who have been treated for gonorrhoea, a test of cure is recommended
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 3
Incorrect
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Which of the following laboratory findings is NOT typical of Hodgkin lymphoma:
Your Answer: Neutrophilia
Correct Answer: Basophilia
Explanation:Features may include:Normochromic normocytic anaemia is most common; bone marrow failure involvement is unusual in early disease, but if it occurs bone marrow failure may develop with leucoerythroblastic anaemiaOne-third of patients have a neutrophilia; eosinophilia is frequentAdvanced disease is associated with lymphopenia and loss of cell-mediated immunityPlatelet count is normal or increased in early disease and reduced in later stagesESR and CRP are usually raised (ESR is useful in monitoring disease progress)Serum LDH is raised initially in 30-40% of casesDiagnosis is made by histological examination of an excised lymph nodeThe distinctive multinucleate polypoid RS cell is central to the diagnosis of the four classic types of HL (95% of cases)
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This question is part of the following fields:
- Haematology
- Pathology
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Question 4
Incorrect
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When the breast cancer of a 60-year old patient metastasizes and compresses the intervertebral foramina between the fourth and fifth cervical vertebrae, as well as the fourth and fifth thoracic vertebrae, this causes back pain. Which pair of nerves is most likely affected?
Your Answer: Fourth cervical and fourth thoracic nerves
Correct Answer: Fifth cervical and fourth thoracic nerves
Explanation:The fifth cervical nerve passes between the fourth and fifth cervical vertebrae, and the fourth thoracic nerve passes between the fourth and fifth thoracic vertebrae. Therefore, when the cancer metastasizes in this area, they are most likely affected.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 5
Correct
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A patient is found to be anaemic. Which one of the following blood results would favour a diagnosis of anaemia of chronic disease rather than iron deficiency:
Your Answer: Low total iron binding capacity (TIBC)
Explanation:Anaemia of chronic disease is one of the most common causes of normocytic anaemia. The anaemia is usually mild (Hb > 90 g/L) and non-progressive. Anaemia of chronic disease is usually associated with low serum iron, low transferrin saturation, and a low total iron binding capacity (TIBC) with normal or raised ferritin which differentiates it from iron deficiency anaemia.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 6
Incorrect
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In the small intestine, there is a deep gap between each villus that leads to the crypt of Lieberkühn, a tubular intestinal gland.What is the primary function of these glands?
Your Answer: Secretion of secretin
Correct Answer: Production of an alkaline intestinal juice
Explanation:In the small intestine, there is a deep gap between each villus that leads to the crypt of Lieberkühn, a tubular intestinal gland. These glands create an alkaline intestinal juice that is a mixture of water and mucus with a pH of 7.4-7.8. Intestinal juice is released in a volume of 1-2 litres per day in response to distention of the small intestine or the irritating effects of chyme on the intestinal mucosa.
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This question is part of the following fields:
- Gastrointestinal Physiology
- Physiology
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Question 7
Correct
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During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate is born with bilateral deafness as a result of this.From the  following antibiotics, which one is most likely to cause this side effect?Â
Your Answer: Gentamicin
Explanation:Aminoglycosides cross the placenta and are linked to poisoning of the 8th cranial nerve in the foetus, as well as permanent bilateral deafness.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 8
Incorrect
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Gastric emptying is inhibited by all of the following EXCEPT for:
Your Answer: Cholecystokinin
Correct Answer: Parasympathetic stimulation
Explanation:Gastric emptying is decreased by: Enterogastric inhibitory reflexes stimulated by – Distension of the duodenum, The presence of fats in the duodenum (by stimulating release of cholecystokinin), A fall in the pH of chyme in the duodenum, An increase in the osmolality of chyme in the duodenum, Irritation of the mucosal lining of the duodenum, Hormones: Cholecystokinin, Secretin
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 9
Correct
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In adult basic life support, chest compressions should be performed at which of the following rates:
Your Answer: 100 - 120 per minute
Explanation:Chest compressions should be performed at a rate of 100 – 120 per minute.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 10
Incorrect
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Which of the following muscles is most responsible for thigh extension at the hip joint?
Your Answer: Hamstrings, gluteus medius and gluteus minimus
Correct Answer: Hamstrings and gluteus maximus
Explanation:For hip extension, the gluteus maximus and hamstring muscles work together. To compensate for gluteus maximus weakness, the hamstring frequently acts as the primary hip extensor.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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SESSION STATS - PERFORMANCE PER SPECIALTY
