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  • Question 1 - A 55-year-old woman with mild dyspepsia seeks advice from her pharmacist on how...

    Correct

    • A 55-year-old woman with mild dyspepsia seeks advice from her pharmacist on how to deal with her symptoms. In the first instance, the pharmacist advises her to take an over-the-counter antacid. She buys an antacid that contains aluminium hydroxide, which relieves her symptoms but has a negative side effect.She's most likely to have developed which of the following side effects?

      Your Answer: Constipation

      Explanation:

      Aluminium hydroxide is a common antacid that is used to treat ulcer dyspepsia and non-erosive gastro-oesophageal reflux disease.When antacids containing aluminium salts are given to patients with renal impairment, there is a risk of accumulation and aluminium toxicity. If renal function is normal, aluminium accumulation does not appear to be a risk.Because it reduces gastrointestinal phosphate absorption, aluminium hydroxide can also be used to treat hyperphosphatemia in patients with renal failure.Magnesium-based antacids are generally laxative, whereas aluminium-based antacids can be constipating. Renal impairment, angioedema, and anaphylaxis are not significantly increased.

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      52.3
      Seconds
  • Question 2 - A 29 year old patient with known inflammatory bowel disease presents to ED...

    Correct

    • A 29 year old patient with known inflammatory bowel disease presents to ED with surgical complications following his recent ileocaecal resection. Removal of the terminal ileum may result in the malabsorption of which of the following:

      Your Answer: Vitamin B12

      Explanation:

      On ingestion, vitamin B12 is bound to R protein found in saliva and gastric secretions, which protects it from digestion in the stomach. Intrinsic factor is secreted by gastric parietal cells. Receptors for the IF-B12 complex are present in the membrane of epithelial cells of the terminal ileum, which bind the complex and allow uptake of vitamin B12 across the apical membrane by endocytosis. Vitamin B12 is then transported across the basal membrane into the portal blood where it is bound to transcobalamin II and processed by the liver. In pernicious anaemia, there are autoantibodies against gastric parietal cells and intrinsic factor, resulting in vitamin B12 deficiency anaemia.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      88.4
      Seconds
  • Question 3 - Which of the following nerves is responsible for the symptoms of a patient...

    Incorrect

    • Which of the following nerves is responsible for the symptoms of a patient with history of recurrent herpes simplex outbreaks on his face and presents with ophthalmic herpes zoster and a painful vesicle on the tip of his nose?

      Your Answer: Infraorbital nerve

      Correct Answer: Nasociliary nerve

      Explanation:

      Hutchinson sign relates to involvement of the tip of the nose from facial herpes zoster. It implies involvement of the external nasal branch of the nasociliary nerve which is a branch of the ophthalmic division of the trigeminal nerve. The nasociliary branch of the trigeminal nerve innervates the apex and lateral aspect of the nose, as well as the cornea. Therefore, lesions on the side or tip of the nose should raise suspicion of ocular involvement.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      16.3
      Seconds
  • Question 4 - Surface area of the absorptive surface in the small intestine is increased by...

    Incorrect

    • Surface area of the absorptive surface in the small intestine is increased by all but which of the following:

      Your Answer: Plicae circulares

      Correct Answer: Teniae coli

      Explanation:

      Factors increasing the surface area include:The small intestine is very long – about 5 m in length.The inner wall of the small intestine is covered by numerous folds of mucous membrane called plicae circulares.The lining of the small intestine is folded into many finger-like projections called villi.The surface of the villi is covered with a layer of epithelial cells which, in turn, have many small projections called microvilli that project towards the lumen of the intestine (forming the brush border).

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      45.4
      Seconds
  • Question 5 - A patient has an elevated potassium level of 6.7 mmol/L. All of the...

    Correct

    • A patient has an elevated potassium level of 6.7 mmol/L. All of the following conditions may cause elevated potassium levels, except for which one?

      Your Answer: Bartter’s syndrome

      Explanation:

      Bartter’s syndrome is an autosomal recessive renal tubular disorder characterized by hypokalaemia, hypochloraemia, metabolic alkalosis, and hyperreninemia with normal blood pressure. The underlying kidney abnormality results in excessive urinary losses of sodium, chloride, and potassium. Bartter’s syndrome does not cause an elevated potassium level, but instead causes a decrease in its concentration (hypokalaemia). The other choices are causes of hyperkalaemia or elevated potassium levels. Renal failure, Addison’s disease (adrenal insufficiency), congenital adrenal hyperplasia, renal tubular acidosis (type 4), rhabdomyolysis, burns and trauma, tumour syndrome, and acidosis are non-drug causes of hyperkalaemia. On the other hand, drugs that can cause hyperkalaemia include ACE inhibitors, angiotensin receptor blockers, NSAIDs, beta-blockers, digoxin, and suxamethonium.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      25.2
      Seconds
  • Question 6 - A 67-year-old woman arrives at the Emergency Department with chest pain. Flecainide is...

    Incorrect

    • A 67-year-old woman arrives at the Emergency Department with chest pain. Flecainide is one of the medications she is taking.Which of the following statements about flecainide mechanism of action is correct?

      Your Answer: Blocks Ca 2+ channels in the heart

      Correct Answer: Blocks Na+ channels in the heart

      Explanation:

      Flecainide is an antiarrhythmic drug of class Ic that works by blocking the Nav1.5 sodium channel in the heart, prolonging the cardiac action potential and slowing cardiac impulse conduction. It has a significant impact on accessory pathway conduction, particularly retrograde conduction, and significantly reduces ventricular ectopic foci.Many different arrhythmias can be treated with flecainide, including:Pre-excitation syndromes (e.g. Wolff-Parkinson-White)Acute atrial arrhythmiasVentricular arrhythmiasChronic neuropathic painThe use of flecainide is contraindicated in the following situations:Abnormal left ventricular functionAtrial conduction defects (unless pacing rescue available)Bundle branch block (unless pacing rescue available)Distal block (unless pacing rescue available)Haemodynamically significant valvular heart diseaseHeart failureHistory of myocardial infarctionLong-standing atrial fibrillation where conversion to sinus rhythm not attemptedSecond-degree or greater AV block (unless pacing rescue available)Sinus node dysfunction (unless pacing rescue available)Flecainide should only be used in people who don’t have a structural heart problem. The CAST trial found a significant increase in sudden cardiac death and all-cause mortality in patients with an ejection fraction of less than 40% after a myocardial infarction, where it tended to be pro-arrhythmic.Anti-arrhythmic drugs have a limited and ineffective role in the treatment of atrial flutter. It’s important to keep in mind that flecainide shouldn’t be used by itself to treat atrial flutter. When used alone, there is a risk of inducing 1:1 atrioventricular conduction, which results in an increase in ventricular rate that is paradoxical. As a result, it should be used in conjunction with a beta-blocker or a calcium channel blocker with a rate-limiting effect.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      28.7
      Seconds
  • Question 7 - Which of the following drug classes may cause bronchoconstriction: ...

    Correct

    • Which of the following drug classes may cause bronchoconstriction:

      Your Answer: Beta-blockers

      Explanation:

      Beta-blockers, including those considered to be cardioselective, should usually be avoided in patients with a history of asthma, bronchospasm or a history of obstructive airways disease. However, when there is no alternative, a cardioselective beta-blocker can be given to these patients with caution and under specialist supervision. In such cases the risk of inducing bronchospasm should be appreciated and appropriate precautions taken.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      39.1
      Seconds
  • Question 8 - A 30-year-old man suffers from an open fracture of his forearm. As a...

    Incorrect

    • A 30-year-old man suffers from an open fracture of his forearm. As a consequence of his injury, the nerve that innervates the pronator quadratus muscle was severed. Which of the following statements regarding the pronator quadratus muscle is considered correct?

      Your Answer: It assists with wrist flexion

      Correct Answer: Its deep fibres bind the radius and ulna together

      Explanation:

      Pronator quadratus is a deep-seated, short, flat, and quadrilateral muscle with fibres running in a parallel direction. It arises from the oblique ridge on the anterior surface of the distal fourth of the Ulna. It is inserted in lateral border and anterior surface of the distal fourth of the radius. It is innervated by the anterior interosseous nerve, a branch of the median nerve (C8-T1). It is vascularized by the anterior interosseous artery.The action of the pronator quadratus muscle along with the pronator teres result in the pronation of the radioulnar joint. Contraction of this muscle pulls the distal end of the radius over the ulna, resulting in the pronation of the radioulnar joint

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      882.9
      Seconds
  • Question 9 - Which lobe of the prostate gland is most commonly affected in prostatic carcinoma?...

    Incorrect

    • Which lobe of the prostate gland is most commonly affected in prostatic carcinoma?

      Your Answer:

      Correct Answer: Posterior

      Explanation:

      The periurethral portion of the prostate gland increases in size during puberty and after the age of 55 years due to the growth of non-malignant cells in the transition zone of the prostate that surrounds the urethra. Most cancers develop in the posterior lobe, and cancers in this location may be palpated during a digital rectal examination (DRE).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      0
      Seconds
  • Question 10 - A trauma victim who has been intubated is tachycardic, hypotensive, and has a...

    Incorrect

    • A trauma victim who has been intubated is tachycardic, hypotensive, and has a poor urine output. You feel she is dehydrated and decide to use a central venous catheter to help you manage her. As part of this, you keep an eye on the waveform of central venous pressure (CVP).Which of the following cardiac cycle phases corresponds to the CVP waveform's 'a wave'? 

      Your Answer:

      Correct Answer: End diastole

      Explanation:

      The pressure measured in the right atrium or superior vena cava is known as central venous pressure (CVP). In a spontaneously breathing subject, the usual CVP value is 0-8 cmH2O (0-6 mmHg).The structure of the CVP waveform is as follows:The CVP’s components are listed in the table below:Component of the waveformThe cardiac cycle phase.mechanical eventmechanical event Diastole Atrial contractiona wave C  wave v waveEarly systoleThe tricuspid valve closes and bulges Late Systole Filling of the atrium with systolic blood x descenty descentMid systoleRelaxation of the atrium Early diastoleFilling of the ventricles at an early stage

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      0
      Seconds
  • Question 11 - You review a 37-year-old man with a history of intravenous drug abuse who...

    Incorrect

    • You review a 37-year-old man with a history of intravenous drug abuse who admits to sharing needles in the past. He has a flu-like illness and a rash. Concerned he may be experiencing an HIV seroconversion illness, you order a test.Which of these tests is most reliably used to diagnose HIV at this stage?

      Your Answer:

      Correct Answer: p24 antigen test

      Explanation:

      Serum concentrations of the p24 antigen are usually high in the first few weeks after human immunodeficiency virus (HIV) infection and testing for p24 antigen is therefore a useful way of diagnosing very early infection. P24 is the viral protein that makes up most of the core of the HIV.ELISA and other antibody tests, though a very sensitive way of detecting the presence of HIV, cannot be used in the early stages of the disease. This is because of the window period of 6-12 weeks before antibodies are produced. These tests will be negative during a seroconversion illness.The ‘rapid HIV test’ is an HIV antibody test. It will also be negative during the ‘window period’ since it takes time for antibodies to be produced. It is called the ‘rapid test’ as it can detect antibodies in blood or saliva much quicker than the other antibody tests and results are often back within 20 minutes.CD4 and CD8 counts are usually normal in the early stages of the HIV infection and cannot be used in this case.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 12 - Regarding box and whisker plots, which of the following statements is true? ...

    Incorrect

    • Regarding box and whisker plots, which of the following statements is true?

      Your Answer:

      Correct Answer: 25% of the values lie below the lower quartile

      Explanation:

      A box and whisker plot is defined as a graphical method of displaying variation in a set of data. In most cases, a histogram analysis provides a sufficient display, but a box and whisker plot can provide additional detail while allowing multiple sets of data to be displayed in the same graph.The procedure to develop a box and whisker plot comes from the five statistics below:(1) Minimum value: The smallest value in the data set(2) Second quartile: The value below which the lower 25% of the data are contained(3) Median value: The middle number in a range of numbers(4) Third quartile: The value above which the upper 25% of the data are contained(5) Maximum value: The largest value in the data set

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
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  • Question 13 - A 2-day-old male is referred to a tertiary care hospital by the community...

    Incorrect

    • A 2-day-old male is referred to a tertiary care hospital by the community midwife after a home visit due to jaundice and dyspnoea. After history and examination, the relevant blood work is performed, and the baby is found to have conjugated hyperbilirubinemia. The paediatric team suspects a hepatic origin for jaundice based on the findings. Which one of the following aetiologies is the most likely cause of jaundice in this case?

      Your Answer:

      Correct Answer: Alpha 1-antitrypsin deficiency

      Explanation:

      The presence of dyspnoea makes alpha-1 antitrypsin deficiency the more likely diagnosis as biliary atresia does not cause respiratory symptoms. Deficiency of the enzyme alpha-1 antitrypsin causes uninhibited elastase activity and a decrease in elastic tissue. This causes liver cirrhosis leading to an elevation of conjugated bilirubin and emphysema in the lungs.Rhesus disease, hereditary spherocytosis and breast milk jaundice cause an elevation of unconjugated bilirubin thus ruling it out in this case. Breast milk jaundice occurs due to an inability of the newborn to metabolize the proteins in breast milk. Rhesus disease occurs when an Rh negative mother gives birth to an Rh positive baby. The jaundice would have been accompanied by anaemia and oedema. Hereditary spherocytosis occurs due to extravascular haemolysis as defective RBCs are removed by the spleen. The patient would present with jaundice, splenomegaly and possibly an aplastic crisis (if Parvovirus B19 infection).

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 14 - The results from the study investigating the accuracy of a new diagnostic test can be...

    Incorrect

    • The results from the study investigating the accuracy of a new diagnostic test can be displayed in the following format. How is the negative predictive value calculated:Those with diseaseThose without diseaseTotalTest positiveaba+bTest negativecdc+dTotala+cb+dn=a+b+c+d

      Your Answer:

      Correct Answer: d/(c+d)

      Explanation:

      Negative predictive value (NPV) is the proportion of individuals with a negative test result who do not have the disease.NPV = d/(c+d)

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds
  • Question 15 - Which of the following is NOT a common side effect of adenosine: ...

    Incorrect

    • Which of the following is NOT a common side effect of adenosine:

      Your Answer:

      Correct Answer: Yellow vision

      Explanation:

      Common side effects of adenosine include:ApprehensionDizziness, flushing, headache, nausea, dyspnoeaAngina (discontinue)AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 16 - You've been asked to visit a 20-year-old patient  who has been complaining of stomach pain,...

    Incorrect

    • You've been asked to visit a 20-year-old patient  who has been complaining of stomach pain, diarrhoea, and bloating. The  GP recently saw the patient and is now looking into numerous possible reasons for stomach hypermotility.Which of the following factors contributes to increased stomach motility?

      Your Answer:

      Correct Answer: Gastrin

      Explanation:

      Gastrin is a peptide hormone that aids in gastric motility by stimulating the generation of gastric acid by the parietal cells of the stomach. G-cells in the stomach’s pyloric antrum, the duodenum, and the pancreas release it.The following stimuli cause the release of gastrin:Stimulation of the vagus nerveHypercalcaemiastomach bloatingProteins that have been partially digested, particularly amino acids.The presence of acid and somatostatin inhibits the release of gastrin.Gastrin’s main actions are as follows:Gastric parietal cells are stimulated to release hydrochloric acid.ECL cells are stimulated to produce histamine.Gastric parietal cell maturation and fundal growth stimulationCauses the secretion of pepsinogen by the gastric chief cells.Improves antral muscle mobility stimulates gastric contractionsIncreases gastric emptying rate and stimulates pancreatic secretionGallbladder emptying is induced.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      0
      Seconds
  • Question 17 - A lesion to which part of the optic radiation will result in contralateral...

    Incorrect

    • A lesion to which part of the optic radiation will result in contralateral homonymous inferior quadrantanopia?

      Your Answer:

      Correct Answer: Right parietal lobe

      Explanation:

      A visual loss in the lower left quadrant in both visual fields is an indication of an inferior homonymous. This is due to a lesion of the superior fibres of the optic radiation in the parietal lobe on the contralateral side of the visual pathway.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 18 - Antispasmodic drugs are primarily indicated in which of the following conditions: ...

    Incorrect

    • Antispasmodic drugs are primarily indicated in which of the following conditions:

      Your Answer:

      Correct 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
      0
      Seconds
  • Question 19 - Noradrenaline exhibits its positive inotropic effect by which of the following mechanisms: ...

    Incorrect

    • Noradrenaline exhibits its positive inotropic effect by which of the following mechanisms:

      Your Answer:

      Correct Answer: Binds to beta1-receptors and causes increased Ca2+ entry via L-type channels during the action potential

      Explanation:

      Noradrenaline (the sympathetic neurotransmitter) is a positive inotrope; it binds to β1-adrenoceptors on the membrane and causes increased Ca2+entry via L-type channels during the AP and thus increases Ca2+release from the SR. Noradrenaline also increases Ca2+sequestration into the SR and thus more Ca2+is available for the next contraction. Cardiac glycosides (e.g. digoxin) slow the removal of Ca2+from the cell by inhibiting the membrane Na+pump which generates the Na+gradient required for driving the export of Ca2+; consequently the removal of Ca2+from the myocyte is slowed and more Ca2+is available for the next contraction. Acidosis is negatively inotropic, largely because H+competes for Ca2+binding sites.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 20 - Which of the following statements is correct regarding homeostasis? ...

    Incorrect

    • Which of the following statements is correct regarding homeostasis?

      Your Answer:

      Correct Answer: In negative feedback mechanisms, effectors always act to move the variable in the opposite direction to the change that was originally detected.

      Explanation:

      The vast majority of systems within the body work by negative feedback mechanisms. This negative feedback refers to the way that effectors act to move the variable in the opposite direction to the change that was originally detected. Because there is an inherent time delay between detecting a change in a variable and effecting a response, the negative feedback mechanisms cause oscillations in the variable they control. There is a narrow range of values within which a normal physiological function occurs and this is called the ‘set point’. The release of oxytocin in childbirth is an example of positive feedback.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
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  • Question 21 - A 39-year-old woman's son with meningococcal meningitis was recently admitted to the Paediatric...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds
  • Question 22 - Campylobacter jejuni is primarily spread via which of the following routes: ...

    Incorrect

    • Campylobacter jejuni is primarily spread via which of the following routes:

      Your Answer:

      Correct Answer: Faecal-oral route

      Explanation:

      Campylobacter spp. are a common cause of acute infective gastroenteritis, particularly in children, with Campylobacter jejuni responsible for 90% of Campylobacter gastroenteritis. Infection typically follows ingestion of contaminated meat (most frequently undercooked poultry), unpasteurised milk or contaminated water, following which the microorganism invades and colonises the mucosa of the small intestine.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 23 - Regarding the abductor digiti minimi, which of the following statements is false? ...

    Incorrect

    • Regarding the abductor digiti minimi, which of the following statements is false?

      Your Answer:

      Correct Answer: It assists with flexion of the fifth finger at the middle phalanx

      Explanation:

      Abductor digiti minimi is a short intrinsic muscle of the hand. It belongs to the group of muscles collectively called hypothenar muscles due to their acting on the 5th finger. Besides abductor digiti minimi, other hypothenar muscles include flexor digiti minimi brevis and opponens digiti minimi.The main function of abductor digiti minimi involves abduction of the 5th finger, as well as flexion of its proximal phalanx. Along with other hypothenar muscles, this muscle forms the hypothenar eminence on the medial side of the palm.Like other hypothenar muscles, abductor digiti minimi receives nervous supply from the deep branch of the ulnar nerve, derived from root values C8 and T1.Abductor digiti minimi receives arterial blood supply from the palmar branch of ulnar artery, palmar digital artery, as well as branches of the ulnar side of the superficial palmar arch. The venous blood from the muscle is drained via the venous networks of the palm into the deep veins of the arm (vv. ulnares).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
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  • Question 24 - A 62-year-old woman is brought to the Emergency Department as she is acutely...

    Incorrect

    • A 62-year-old woman is brought to the Emergency Department as she is acutely unwell. Her attendants inform you that she was recently started on lithium as a mood stabilizer. You instantly send a blood sample to check for lithium levels. What is the usual therapeutic range for lithium?

      Your Answer:

      Correct Answer: 0.4-0.8 mmol/l

      Explanation:

      Lithium is the drug of choice for recurrent bipolar illness but should be carefully monitored as it has a very low therapeutic index. The normal therapeutic range is 0.4-0.8 mmol/l. The lower end of the range is usually the target for the elderly and as maintenance therapy. Toxicity is usually seen at levels >1.5 mmol/l. Samples should be taken 12 hours after the dose, and levels should be checked one week after starting therapy and one week after every change in dosage.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
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  • Question 25 - When a child has chickenpox, how long should he or she be off...

    Incorrect

    • When a child has chickenpox, how long should he or she be off from school?

      Your Answer:

      Correct Answer: Until all vesicles have crusted over

      Explanation:

      To avoid the spread of infection, infected patients should be isolated. All lesions should be crusted over before children return to nursery or school, even if the standard exclusion time is 5 days.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
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  • Question 26 - A 42-year-old man presented to the emergency room with complains of a dry...

    Incorrect

    • A 42-year-old man presented to the emergency room with complains of a dry cough and fever that has been going on for the past few days. Upon history taking and observation, it was established that he works as a Jacuzzi and whirlpool installer and smokes 15 cigarettes per day. The presence of a non-productive cough, several episodes of diarrhoea, developed bilateral pleuritic chest pain, and shortness of breath most notably on exertion were also noted.Which of the following is most likely the causative agent of the case presented above?

      Your Answer:

      Correct Answer: Legionella pneumophila

      Explanation:

      Legionella species are ubiquitous, Gram-negative bacilli acquired primarily through inhalation. Infections caused by Legionella spp. produce a spectrum of symptoms ranging from mild upper respiratory tract infections to pneumonia. Legionella spp. are responsible for 2% to 15% of community-acquired pneumonia.Clinical manifestations of Legionella infections include febrile disease with pneumonia (legionnaires’ disease), febrile disease without pulmonary involvement (Pontiac fever), and asymptomatic infection.The mode of transmission and the number of infecting organisms in the inoculum play a role in the clinical features of the infection. In addition, host factors, such as a suppressed immune system, chronic lung disease, alcoholism, and heavy smoking, predispose individuals to legionnaires’ disease.Legionella spp. can tolerate chlorine concentrations of 3 mg/L, they resist water treatment and subsequently gain entry into and colonize human-made water supplies and distribution systems. Hot water systems, cooling towers, and evaporative condensers are major reservoirs. Other sources include cold water systems, ornamental fountains, whirlpool spas, humidifiers, respiratorytherapy equipment, and industrial process waters.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 27 - All of the following typically occurs as part of normal inspiration except: ...

    Incorrect

    • All of the following typically occurs as part of normal inspiration except:

      Your Answer:

      Correct Answer: Contraction of the internal intercostal muscles

      Explanation:

      Passive inspiration is a result of contraction of the diaphragm (depressing the diaphragm) and the external intercostal muscles (elevating the ribs). In inspiration, several movements occur. These are:1. elevation of the sternal ends of the ribs (‘pump handle’ movement), 2. elevation of the lateral shafts of the ribs (‘bucket handle’ movement) 3. depression of the diaphragm. These result in expansion of the thorax in an anteroposterior, transverse and vertical direction respectively. There is an increased intrathoracic volume and decreased intrathoracic pressure and air is drawn into the lungs.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
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  • Question 28 - In adults in the United Kingdom, which of the following pathogens is the...

    Incorrect

    • In adults in the United Kingdom, which of the following pathogens is the most likely cause of viral infectious gastroenteritis:

      Your Answer:

      Correct Answer: Norovirus

      Explanation:

      Norovirus is the most common viral cause of epidemic gastroenteritis worldwide; it is also a common cause of endemic diarrhoea in community settings. In the United Kingdom, norovirus has become the most common cause of gastroenteritis in adults and children since the introduction of rotavirus vaccination.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
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  • Question 29 - A patient presents with a rash for a dermatological examination. A flat circumscribed...

    Incorrect

    • A patient presents with a rash for a dermatological examination. A flat circumscribed area of discoloured skin measuring 0.7 cm in diameter is seen on examination.What is the best description of this rash that you have found on examination?

      Your Answer:

      Correct Answer: Macule

      Explanation:

      A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin. A vesicle is a visible collection of clear fluid measuring less than 0.5 cm in diameter.A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter. A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless.A plaque is a palpable skin lesion that is elevated and measures >1cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 30 - Regarding the UK routine childhood immunisation schedule which of the following vaccines is...

    Incorrect

    • Regarding the UK routine childhood immunisation schedule which of the following vaccines is given at 3 months:

      Your Answer:

      Correct Answer: Rotavirus

      Explanation:

      At 3 months the following vaccines are given:Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B (2nd dose)Pneumococcal (13 serotypes)Rotavirus (2nd dose)

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      0
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SESSION STATS - PERFORMANCE PER SPECIALTY

Gastrointestinal Pharmacology (1/1) 100%
Pharmacology (2/3) 67%
Gastrointestinal (1/2) 50%
Physiology (2/3) 67%
Microbiology (0/1) 0%
Specific Pathogen Groups (0/1) 0%
Renal Physiology (1/1) 100%
Cardiovascular Pharmacology (0/1) 0%
Cardiovascular (1/1) 100%
Anatomy (0/1) 0%
Upper Limb (0/1) 0%
Passmed