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Question 1
Correct
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All of the following statements are correct regarding penicillin antibiotics except:
Your Answer: Penicillins are of no use in meningitis as they are unable to penetrate into the cerebrospinal fluid.
Explanation:Penicillin penetration into the cerebrospinal fluid is generally poor. However, when the meninges are inflamed, as in meningitis, penetration of penicillin is increased. Benzylpenicillin should be given before transfer to hospital if meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) is suspected, once this does not delay transfer. Benzylpenicillin is no longer the drug of first choice for pneumococcal meningitis.
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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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An elderly man with chronic heart and lung disease develops Legionnaires' Disease. By what route was the infection most likely to have been acquired:
Your Answer: Respiratory route, from an infected person
Correct Answer: Inhalation of aerosolised contaminated water
Explanation:Legionella pneumophilais a Gram negative bacterium that is found in natural water supplies and in the soil, transmitted predominantly via inhalation of aerosols generated from contaminated water (direct person-to-person spread of infected patients does not occur). It is the cause of Legionnaires’ disease. Outbreaks of Legionnaires’ disease have been linked to poorly maintained air conditioning systems, whirlpool spas and hot tubs.The clinical features of the pneumonic form of Legionnaires’ disease include:Mild flu-like prodrome for 1-3 daysCough (usually non-productive and occurs in approximately 90%)Pleuritic chest painHaemoptysisHeadacheNausea, vomiting and diarrhoeaAnorexiaLegionella pneumophilainfections can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used.The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur with Legionnaires’ disease and will result in hyponatraemia as is seen in this case.Legionella pneumophilainfections are resistant to amoxicillin but can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used. The majority of cases of Legionnaires’ disease are caused by Legionella pneumophila, however many other species of Legionella have been identified.Legionella longbeachae is another less commonly encountered species that has also been implicated in outbreaks. It is predominantly found in soil and potting compost, and has caused outbreaks of Pontiac fever, the non-respiratory and less severe variant of Legionnaires’ disease.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 3
Correct
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Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or rectosigmoid should be treated initially with:
Your Answer: Local aminosalicylate
Explanation:Acute mild to moderate disease affecting the rectum (proctitis) or the rectosigmoid is treated initially with local application of an aminosalicylate; alternatively, a local corticosteroid can be used but it is less effective. A combination of a local aminosalicylate and a local corticosteroid can be used for proctitis that does not respond to a local aminosalicylate alone.
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This question is part of the following fields:
- Gastrointestinal
- Pharmacology
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Question 4
Correct
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Which of the following is NOT a common side effect of antihistamines:
Your Answer: Tremor
Explanation:Common side effects of antihistamines may include:Anticholinergic effects (blurred vision, dry mouth, urinary retention)HeadacheGastrointestinal disturbancesPsychomotor impairment (sedation, dizziness and loss of appetite)These side effects are significantly reduced with second-generation agents.
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This question is part of the following fields:
- Pharmacology
- Respiratory
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Question 5
Incorrect
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A blood test of a 7-year-old child with a 6-day history of bloody diarrhoea reveals a low platelet count, anaemia, and impaired kidney function. What bacteria is suspected of causing such a condition?
Your Answer: Campylobacter jejuni
Correct Answer: Escherichia coli
Explanation:Escherichia coli produces shiga toxin that causes diarrhoea, hemorrhagic colitis, and haemolytic uremic syndrome. Haemolytic uremic syndrome is characterized by anaemia, thrombocytopenia, and acute renal failure. Transmission of E. coli is possible after consuming contaminated, undercooked drinks and foods. E. coli enters the body via the faecal-oral pathway.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 6
Correct
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One of these statements about significance tests is true.
Your Answer: A p value of less than 1 in 20 is considered ‘statistically significant’
Explanation:The p value is statistically significant when it is less than 0.05 (5% or 1 in 20).Statistical significance is not the same as clinical significance. The null hypothesis states that there is no difference between the groups.The power of a study is the probability of correctly rejecting the null hypothesis when it is false.A type I error occurs when the null hypothesis has been rejected when it is true. A type II error occurs when the null hypothesis has been accepted when it is actually false.
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This question is part of the following fields:
- Evidence Based Medicine
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Question 7
Correct
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A blood culture was performed from a sample taken from a patient. It was noted that a Gram-positive coccus organism was grown.Among the following microorganisms, which is considered an example of a Gram-positive coccus?
Your Answer: Staphylococcus aureus
Explanation:Bacillus cereus = Gram-positive bacillusNeisseria meningitidis = Gram-negative coccusSalmonella enterica & Escherichia coli = Gram-negative bacilliIn Gram staining, crystal violet is a purple stain that is used to stain the bacteria first. The stained bacteria are decolorized and then stained with a red stain, which is safranin. Bacteria with thick cell walls keep the purple stain and are called Gram-positive. Thin-walled bacteria are easily decolorized so when safranin, the red stain, is placed on the organisms, they become red or Gram-negative. The Staphylococci that are associated with infections in humans are colonizers of various skin and mucosal surfaces. Because the carrier state is common among the human population, infections are frequently acquired when the colonizing strain gains entrance to a normally sterile site as a result of trauma or abrasion to the skin or mucosal surface.
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This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 8
Correct
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Which of the following is NOT a contraindication to the use of diazepam:
Your Answer: Acute alcohol withdrawal
Explanation:Benzodiazepines are used to treat symptoms in patients with acute alcohol withdrawal syndrome. Benzodiazepines are contraindicated in: Respiratory depressionMarked neuromuscular respiratory weakness, such as unstable myasthenia gravisObstructive sleep apnoea syndrome (symptoms may be aggravated)Severe hepatic impairment (the elimination half-life of diazepam may be prolonged; increased risk of coma)Phobic or obsessional states, chronic psychosis or hyperkinesis (paradoxical reactions may occur).
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 9
Incorrect
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About what percentage of patients with hepatitis A develop chronic infection:
Your Answer: 0.1
Correct Answer: None
Explanation:Chronic hepatitis and carrier state does not occur in hepatitis A infection and complete immunity is attained after infection.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 10
Incorrect
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Which of the following does NOT typically cause a neutrophil leucocytosis:
Your Answer: Myocardial infarction
Correct Answer: Glandular fever
Explanation:Causes of neutrophil leucocytosis:Bacterial infectionInflammation and tissue necrosis (e.g. cardiac infarct, trauma, vasculitis, myositis)Metabolic disorders (e.g. uraemia, acidosis, eclampsia, gout)PregnancyAcute haemorrhage or haemolysisNeoplasms of all typesDrugs (e.g. corticosteroid therapy, lithium, tetracyclines)AspleniaMyeloproliferative disorders (e.g. CML, essential thrombocythaemia, polycythaemia vera, myelofibrosis)Rare inherited disorders
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This question is part of the following fields:
- Immune Responses
- Pathology
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SESSION STATS - PERFORMANCE PER SPECIALTY
