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  • Question 1 - You've been asked to give a discussion to a group of medical students...

    Incorrect

    • You've been asked to give a discussion to a group of medical students about skeletal muscle physiology and its use in clinical medicine. They pose a series of difficult questions to you.Which of the following definitions for the A-band of the sarcomere is correct?

      Your Answer: Zones of thin filaments extending from either side of the Z-lines to the start of the thick filament (myosin)

      Correct Answer: A band that contains the entire length of a single thick filament (myosin)

      Explanation:

      Myofibrils, which are around 1 m in diameter, make up each myofiber. The cytoplasm separates them and arranges them in a parallel pattern along the cell’s long axis. These myofibrils are made up of actin and myosin filaments that are repeated in sarcomeres, which are the myofiber’s basic functional units.Myofilaments are the filaments that make up myofibrils, and they’re made mostly of proteins. Myofilaments are divided into three categories:Myosin filaments are thick filaments made up mostly of the protein myosin.Actin filaments are thin filaments made up mostly of the protein actin.Elastic filaments are mostly made up of the protein titin.The sarcomere is a Z-line segment that connects two adjacent Z-lines.The I-bands are thin filament zones that run from either side of the Z-lines to the thick filament’s beginning.Between the I-bands is the A-band, which spans the length of a single thick filament.The H-zone is a zone of thick filaments that is not overlaid by thin filaments in the sarcomere’s centre. The H-zone keeps the myosin filaments in place by surrounding them with six actin filaments each.The M-band (or M-line) is a disc of cross-connecting cytoskeleton elements in the centre of the H-zone.The thick filament is primarily made up of myosin. The thin filament is primarily made up of actin. Actin, tropomyosin, and troponin are found in a 7:1:1 ratio in thin filaments.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      47.5
      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
      14.3
      Seconds
  • Question 3 - Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for: ...

    Incorrect

    • Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for:

      Your Answer: Hypochloraemic alkalosis

      Correct Answer: Hypocalcaemia

      Explanation:

      Common side effects of thiazide diuretics include:Excessive diuresis, postural hypotension, dehydration, renal impairmentAcid-base and electrolyte imbalanceHypokalaemia, hyponatraemia, hypomagnesaemia, hypercalcaemia, hypochloraemic alkalosisMetabolic imbalanceHyperuricaemia and goutImpaired glucose tolerance and hyperglycaemiaAltered plasma-lipid concentrationsMild gastrointestinal disturbances

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      12.8
      Seconds
  • Question 4 - You're a member of the cardiac arrest team, and you're helping to resuscitate...

    Incorrect

    • You're a member of the cardiac arrest team, and you're helping to resuscitate an elderly gentleman who had collapsed at home. The team leader requests that you administer an adrenaline shot.Which of the following statements about adrenaline is FALSE?

      Your Answer: It may be administered via an endotracheal tube

      Correct Answer: The IM dose in anaphylaxis is 1 ml of 1:1000

      Explanation:

      Adrenaline (epinephrine) is a sympathomimetic amine that binds to alpha- and beta-adrenergic receptors and acts as an agonist. It is active at both alpha and beta receptors in roughly equal amounts.When taken orally, it becomes inactive. Subcutaneous absorption is slower than intramuscular absorption. In cardiac arrest, it is well absorbed from the tracheal mucosa and can be given through an endotracheal tube.At the adrenergic synapse, catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO) metabolise it primarily. The inactive products are then passed through the kidneys and excreted in the urine.In adult cardiac arrest, the IV dose is 1 mg, which is equal to 10 ml of 1:10000 or 1 ml of 1:1000. In anaphylaxis, the IM dose is 0.5 ml of 1:1000. (500 mcg).In open-angle glaucoma, adrenaline causes mydriasis and lowers pressure.Adrenaline is used in cardiopulmonary resuscitation, the treatment of severe croup, and the emergency management of acute allergic and anaphylactic reactions (as a nebuliser solution).

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      47.2
      Seconds
  • Question 5 - A patient allergic to penicillin and with marked cellulitis presents and you decide...

    Incorrect

    • A patient allergic to penicillin and with marked cellulitis presents and you decide to start him on erythromycin.Which statement about macrolide antibiotics is true?

      Your Answer: They act by binding to the 30S subunit of the bacterial ribosome

      Correct Answer: They are actively concentrated within leukocytes

      Explanation:

      Macrolide antibiotics are bacteriostatic. They act by binding to the 50S subunit of the bacterial ribosome inhibit protein synthesis. Macrolide antibiotics are actively concentrated within leukocytes, because of this, they are transported into the site of infection.Macrolide antibiotics are not effective in meningitis as they do not penetrate the central nervous system well. They are mainly against Gram-positive organisms and can be used as an alternative in patients with penicillin allergy.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      31.2
      Seconds
  • Question 6 - A 69-year-old woman with new-onset back pain was diagnosed with osteopenia, osteolytic lesions,...

    Correct

    • A 69-year-old woman with new-onset back pain was diagnosed with osteopenia, osteolytic lesions, and vertebral collapse after undergoing a radiographic examination. Her laboratory results revealed anaemia and hypercalcemia. These findings most likely indicate what condition?

      Your Answer: Myeloma

      Explanation:

      Bone pain, pathologic fractures, weakness, anaemia, infection, hypercalcemia, spinal cord compression, and renal failure are all signs and symptoms of multiple myeloma (MM). The patient’s condition matched the signs and symptoms of myeloma.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      24.7
      Seconds
  • Question 7 - A mother has serious concerns about vaccinating her child. She has read about...

    Incorrect

    • A mother has serious concerns about vaccinating her child. She has read about many contraindications and risks in the papers and would like to discuss them with you.One of these is a valid contraindication to vaccination.

      Your Answer: History of skin rash following egg ingestion

      Correct Answer: None of the other options

      Explanation:

      The options listed in this question are not true contraindications to vaccination. Therefore, the correct answer is ‘none of the other options’.The contraindications to vaccination are:Confirmed anaphylactic reaction to a previous dose of the vaccine or a vaccine containing the same antigens.A confirmed anaphylactic reaction to another component in the vaccine.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      20.4
      Seconds
  • Question 8 - A 69-year-old man with a history of chronic anaemia is transfused. He takes...

    Correct

    • A 69-year-old man with a history of chronic anaemia is transfused. He takes bisoprolol and furosemide for his cardiac failure, and his most recent BNP was 123 pmol/l. He developed shortness of breath and his pre-existing peripheral oedema became worse 5 hours after transfusion was commenced. His BP rises to 170/105 mmHg and a repeat measurement of his BNP is 192 pmol/l.What is the most likely transfusion reaction to have occurred?

      Your Answer: TACO

      Explanation:

      Transfusion-associated circulatory overload (TACO) presents as acute or worsening respiratory distress within 6 hours of transfusion of a large volume of blood. It is common in patients with diminished cardiac reserve or chronic anaemia. Elderly patients, infants and severely anaemic patients are particularly susceptible. Typical clinical features of TACO include: Acute respiratory distress, Tachycardia, Hypertension, Acute/worsening pulmonary oedema on chest X-ray. The BNP is usually raised to at least 1.5 times the pre-transfusion baseline.Febrile transfusion reaction presents with a 1 degree rise in temperature from baseline during transfusion. Patient may have chills and malaise. It is the most common transfusion reaction (1 in 8 transfusions) and is usually caused by cytokines released from leukocytes in transfused red cell or platelet components. TRALI (Transfusion Related Acute Lung Injury) is a clinical syndrome with abrupt onset of non-cardiogenic pulmonary oedema within 6 hours of transfusion not explained by another risk factor. Associated with the presence of antibodies in the donor blood to recipient leukocyte antigens. patients present with dyspnoea, hypertension, hypotension, acute leukopenia. Graft versus host disease(GVHD) is an immune mediated condition that arises from a complex interaction between donor and recipients adaptive immunity. It presents as dermatitis, hepatitis and enteritis developing within 100 days after stem cell or bone marrow transplant.Acute haemolytic reaction aka immediate haemolytic transfusion reaction presents with fever, chills, pain at transfusion site, nausea, vomiting, dark urine and feeling of ‘impending doom’. Often, it occurs due to ABO incompatibility.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      26
      Seconds
  • Question 9 - How is filtered K+mainly reabsorbed in the thick ascending limb of the loop...

    Incorrect

    • How is filtered K+mainly reabsorbed in the thick ascending limb of the loop of Henle:

      Your Answer: Primary active transport via Na + /K + ATPase

      Correct Answer: Secondary active transport via Na + /K + /2Cl - cotransporter

      Explanation:

      Around 30% of filtered K+is reabsorbed in the thick ascending limb of the loop of Henle, primarily via the luminal Na+/K+/2Cl-cotransporter, but there is also significant paracellular reabsorption, encouraged by the positive potential in the tubular lumen.

    • This question is part of the following fields:

      • Physiology
      • Renal
      20.2
      Seconds
  • Question 10 - Which of the following best describes the typical rash of measles: ...

    Incorrect

    • Which of the following best describes the typical rash of measles:

      Your Answer: The typical rash of measles progresses from macules to papules to vesicles before crusting over.

      Correct Answer: The typical rash of measles is maculopapular, starting behind the ears and spreading downwards to the trunk.

      Explanation:

      A prodromal 2 – 4 day coryzal illness (fever, cough, conjunctivitis, irritability) normally occurs associated with Koplik’s spots (small white papules found on the buccal mucosa near the first premolars), before a morbilliform maculopapular rash appears, first behind the ears and then spreading downwards to whole body.The rash peels off or fades about about 7 – 10 days. The chickenpox rash is characterised by a maculopapular rash progressing to vesicles and then crusting over. Scarlet fever is characterised by a sandpaper like rash associated with a strawberry tongue.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      29.5
      Seconds
  • Question 11 - A 59-year-old man presents to the emergency room with chest pain. He was...

    Incorrect

    • A 59-year-old man presents to the emergency room with chest pain. He was recently released from the hospital after receiving abciximab during coronary angioplasty.Which of the following is abciximab (ReoPro) mechanism of action?

      Your Answer: Reversible inactivation of cyclooxygenase (COX)

      Correct Answer: Antagonism of the glycoprotein IIb/IIIa receptor

      Explanation:

      Abciximab (ReoPro) is a glycoprotein IIb/IIIa receptor antagonist that is a chimeric monoclonal antibody. It is primarily used during and after coronary artery procedures such as angioplasty to inhibit platelet aggregation.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      32.9
      Seconds
  • Question 12 - 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
      31
      Seconds
  • Question 13 - A 25 year old man presents to the emergency room with abdominal pain,...

    Correct

    • A 25 year old man presents to the emergency room with abdominal pain, vomiting and constipation. A CT scan is done which is suggestive of Meckel's diverticulum. Where does the blood supply of the Meckel's diverticulum originate?

      Your Answer: Superior mesenteric artery

      Explanation:

      Meckel’s diverticulum has certain classic characteristics.1. It lies on the antimesenteric border of the middle-to-distal ileum2. It is approximately 2 feet proximal to the ileocaecal junction3. It appears as a blind-ended tubular outpouching of bowel4. It is about 2 inches long, 5. It occurs in about 2% of the population, 6. It may contain two types of ectopic tissue (gastric and pancreatic). 7. The diverticulum is supplied by the superior mesenteric artery.8. Proximal to the major duodenal papilla the duodenum is supplied by the gastroduodenal artery (branch of the coeliac trunk)9. Distal to the major duodenal papilla it is supplied by the inferior pancreaticoduodenal artery (branch of superior mesenteric artery).10. The arterial supply to the jejunoileum is from the superior mesenteric artery.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      18.5
      Seconds
  • Question 14 - Nitric oxide release from endothelium is stimulated by all of the following EXCEPT...

    Incorrect

    • Nitric oxide release from endothelium is stimulated by all of the following EXCEPT for:

      Your Answer: Bradykinin

      Correct Answer: Noradrenaline

      Explanation:

      Nitric oxide (NO) production by the endothelium is increased by factors that elevate intracellular Ca2+, including local mediators such as bradykinin, histamine and serotonin, and some neurotransmitters (e.g. substance P). Increased flow (shear stress) also stimulates NO production and additionally activates prostacyclin synthesis. The basal production of NO continuously modulates vascular resistance; increased production of nitric oxide acts to cause vasodilation. Nitric oxide also inhibits platelet activation and thrombosis.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      13.5
      Seconds
  • Question 15 - Which of the following nerves supply the superficial head of the flexor pollicis...

    Incorrect

    • Which of the following nerves supply the superficial head of the flexor pollicis brevis muscle?

      Your Answer: The palmar digital branch of the median nerve

      Correct Answer: The recurrent branch of the median nerve

      Explanation:

      The two heads of the flexor pollicis brevis usually differ in their innervation. The superficial head of flexor pollicis muscle receives nervous supply from the recurrent branch of the median nerve, whereas the deep head receives innervation from the deep branch of the ulnar nerve, derived from spinal roots C8 and T1.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      23.5
      Seconds
  • Question 16 - A critically ill 48-year-old individual appears with symptoms and signs of an anaphylactic...

    Correct

    • A critically ill 48-year-old individual appears with symptoms and signs of an anaphylactic reaction.In an allergic reaction, which of the following is an absolute contraindication to the injection of adrenaline?

      Your Answer: None of the other options

      Explanation:

      Even if the following relevant contraindications exist, adrenaline can be given in life-threatening anaphylactic reactions:Coronary artery disease (CAD) Coronary artery disease (CAD)  Second stage of labourHypertension that is uncontrolledSevere Ventricular arrhythmias

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      12.7
      Seconds
  • Question 17 - A 26-year-old male presents to your clinic with the complaint of recurrent fevers...

    Incorrect

    • A 26-year-old male presents to your clinic with the complaint of recurrent fevers over the past three months. On documentation of the fever, it is noted that the fever increases and decreases in a cyclical pattern over a 1-2 week period. After the appropriate investigations, a diagnosis of Pel-Ebstein fever is made. Which ONE of the following conditions is most likely to cause this patient's fever?

      Your Answer: Non-Hodgkin lymphoma

      Correct Answer: Hodgkin lymphoma

      Explanation:

      The release of cytokines from Reed-Sternberg cells can cause fever in patients with Hodgkin lymphoma, which increases and decreases in a cyclical pattern of 1 to 2 weeks. This is called Pel-Ebstein or Ebstein-Cardarelli fever, specifically seen in Hodgkin lymphoma. The fever is always high grade and can reach 40 degrees or higher.Cyclical fever in other conditions is common but is not termed as Pel-Ebstein fever. This term is reserved only with Hodgkin lymphoma.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      29.5
      Seconds
  • Question 18 - A 29 year old woman is unable to invert her foot after sustaining...

    Incorrect

    • A 29 year old woman is unable to invert her foot after sustaining an injury to her leg playing water-polo. Which of the following nerves are most likely damaged:

      Your Answer: Tibial and obturator nerve

      Correct Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is primarily produced by the tibialis anterior and the tibialis posterior muscles, innervated by the deep fibular nerve and the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      23.5
      Seconds
  • Question 19 - A 30-year-old man suffers from an open femoral shaft fracture after being involved...

    Incorrect

    • A 30-year-old man suffers from an open femoral shaft fracture after being involved in a road traffic accident. As a consequence of his injury, the nerve that was damaged innervates the popliteus muscle.In which of the following nerves is the popliteus muscle innervated by?

      Your Answer: Femoral nerve

      Correct Answer: Tibial nerve

      Explanation:

      The popliteus muscle is innervated by the tibial nerve (L4, 5 and S1).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      30.4
      Seconds
  • Question 20 - A young male has presented to you with respiratory depression and small pupils...

    Correct

    • A young male has presented to you with respiratory depression and small pupils on examination. You diagnose opioid overdose and immediately start therapy with Naloxone.Which of the following statements is TRUE regarding naloxone?

      Your Answer: It can be given by a continuous infusion if repeated doses are required

      Explanation:

      Naloxone is a short-acting, specific antagonist of mu(μ)-opioid receptors. It is used to reverse the effects of opioid toxicity. It can be given by a continuous infusion if repeated doses are required and the infusion rate is adjusted according to the vital signs. Initially, the infusion rate can be set at 60% of the initial resuscitative IV dose per hour.Naloxone has a shorter duration of action (6-24 hours) than most opioids and so close monitoring according to the respiratory rate and depth of coma and repeated injections are necessary. When repeated doses are needed in opioid addicts, naloxone administration may precipitate a withdrawal syndrome with abdominal cramps, nausea and diarrhoea, but these usually settle within 2 hours.An initial dose of 0.4 to 2 mg can be given intravenously and can be repeated at 2 to 3-minute intervals to a maximum of 10mg. If the intravenous route is inaccessible, naloxone can be administered via an IO line, subcutaneously (SQ), IM, or via the intranasal (IN) route.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      23.4
      Seconds
  • Question 21 - Which of the following statements is correct with regards to insulin receptors? ...

    Incorrect

    • Which of the following statements is correct with regards to insulin receptors?

      Your Answer: Insulin has its intracellular effects via the increased production of cAMP.

      Correct Answer: Insulin has its intracellular effects via activation of tyrosine kinase.

      Explanation:

      Most cells have insulin receptors present on them which can be sequestered into the cell to inactivate them. These receptors consist of two extracellular alpha subunits which contain the insulin-binding site and two transmembrane beta subunits. Because insulin is a polypeptide hormone, it must act via cell surface receptors as it is unable to readily cross the cell membrane. On binding to the receptor, the beta subunit of insulin autophosphorylation, which activates tyrosine kinase. As a result, there is an intracellular cascade of phosphorylation, causing a translocation of the glucose transporter GLUT4 and GLUT-1 to the plasma membrane of the affected cell. This facilitates glucose entry.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      24.2
      Seconds
  • Question 22 - A 62-year-old woman is brought to the Emergency Department as she is acutely...

    Correct

    • 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: 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
      5.2
      Seconds
  • Question 23 - Which of the following statements regarding the pituitary gland is CORRECT: ...

    Incorrect

    • Which of the following statements regarding the pituitary gland is CORRECT:

      Your Answer: Hypothalamic hormones are transported to the posterior pituitary by hypophyseal portal vessels.

      Correct Answer: Cortisol inhibits release of adrenocorticotropic hormone (ACTH) from the anterior pituitary.

      Explanation:

      Anterior pituitary hormones are released under the control of hypothalamic releasing or inhibiting hormones originating from small neurons with their cell bodies in the hypothalamus and released into the blood at the median eminence. These hypothalamic hormones are transported directly to the anterior pituitary via hypophyseal portal vessels. The anterior pituitary hormones (and the hormones released by their target organs) inhibit further release of hypothalamic and anterior pituitary hormones by negative feedback mechanisms e.g. cortisol inhibits the release of ACTH. Prolactin release from the anterior pituitary is inhibited by dopamine.The posterior pituitary is really a direct extension of the hypothalamus. Oxytocin and ADH are manufactured in the cell bodies of large neurons in the hypothalamus and are transported down the axons of these cells to their terminals on capillaries originating from the inferior hypophyseal artery within the posterior pituitary gland. ADH release is controlled by negative feedback mechanisms based on plasma osmolality and blood volume, oxytocin however is involved in positive feedback mechanisms.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      28.1
      Seconds
  • Question 24 - The correct statement about the glomerular filtration barrier is which of the following?...

    Correct

    • The correct statement about the glomerular filtration barrier is which of the following?

      Your Answer: The basement membrane is negatively charged, restricting filtration of negatively charged molecules.

      Explanation:

      The main factor in determining whether a substance is filtered or not is molecular weight. Molecules < 7 kDa in molecular weight e.g. glucose, amino acids, urea, ions are filtered freely, but larger molecules are increasingly restricted up to 70 kDa, and there is very little filtration for anything above this. There is further restriction of negatively charged molecules because they are repelled by negative charges, particularly in the basement membrane. Albumin, which has a molecular weight of 69 kDa and is negatively charged, is filtered but only in very small amounts. All of the filtered albumin is reabsorbed in the proximal tubule. Small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. Other than the ultrafiltrate being essentially protein free, it has an otherwise identical composition of plasma. Bowman's capsule consists of:- an epithelial lining which consists of a single layer of cells called podocytes- endothelium which is perforated by pores or fenestrations – this allows plasma components with a molecular weight of < 70 kDa to pass freely.

    • This question is part of the following fields:

      • Physiology
      • Renal
      6.2
      Seconds
  • Question 25 - A 25-year-old footballer develops pain and stiffness in his thigh. A diagnosis of...

    Incorrect

    • A 25-year-old footballer develops pain and stiffness in his thigh. A diagnosis of iliopsoas syndrome is made.Iliacus is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: Anterior rami of lumbar nerves L1-L3

      Correct Answer: Femoral nerve

      Explanation:

      Iliacus is innervated by the femoral nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      23.1
      Seconds
  • Question 26 - A patient who is taking ramipril for high blood pressure complains of a...

    Incorrect

    • A patient who is taking ramipril for high blood pressure complains of a dry persistent cough. What is the mechanism of cough in ACE inhibitor therapy:

      Your Answer: Increased histamine release

      Correct Answer: Decreased bradykinin breakdown

      Explanation:

      Blocking ACE also diminishes the breakdown of the potent vasodilator bradykinin which is the cause of the persistent dry cough. Angiotensin-II receptor blockers do not have this effect, therefore they are useful alternative for patients who have to discontinue an ACE inhibitor because of persistent cough.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      13.6
      Seconds
  • Question 27 - Arterial baroreceptors are located primarily in which of the following: ...

    Incorrect

    • Arterial baroreceptors are located primarily in which of the following:

      Your Answer: Carotid sinus and right atrium

      Correct Answer: Carotid sinus and aortic arch

      Explanation:

      Arterial baroreceptors are located in the carotid sinus and aortic arch, and detect the mean arterial pressure (MAP). A decrease in MAP (such as in postural hypotension, or haemorrhage) reduces arterial stretch and decreases baroreceptor activity, resulting in decreased firing in afferent nerves travelling via the glossopharyngeal nerve (carotid sinus) and vagus nerve (aortic arch) to the medulla where the activity of the autonomic nervous system is coordinated. Sympathetic nerve activity consequently increases, causing an increase in heart rate and cardiac contractility, peripheral vasoconstriction with an increase in TPR, and venoconstriction with an increase in CVP and thus an increase in cardiac output and blood pressure. Parasympathetic activity (vagal tone) decreases, contributing to the rise in heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      20.7
      Seconds
  • Question 28 - You've been asked to visit a 20-year-old patient  who has been complaining of stomach pain,...

    Correct

    • 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: 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
      16.6
      Seconds
  • Question 29 - A p value < 0.05 obtained from a study with a significance level...

    Incorrect

    • A p value < 0.05 obtained from a study with a significance level (α) of 0.05, means all of the following, EXCEPT:

      Your Answer: the null hypothesis is rejected.

      Correct Answer: the result is clinically significant.

      Explanation:

      A p value < 0.05:is statistically significantmeans that the probability of obtaining a given result by chance is less than 1 in 20means the null hypothesis is rejectedmeans there is evidence of an association between a variable and an outcomeNote that this does not tell us whether the result is clinically significant.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      37
      Seconds
  • Question 30 - Regarding propofol, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding propofol, which of the following statements is INCORRECT:

      Your Answer: Propofol decreases the ventilatory response to carbon dioxide.

      Correct Answer: A lower induction dose of propofol is required in children.

      Explanation:

      Elderly patients have a reduced volume of distribution and slower clearance of the drug. They are therefore more sensitive to the effects of propofol and the drug wears off more slowly. They need less of the drug, which should be injected slowly, monitoring its effect on the patient. The opposite is true in children, who need larger doses of propofol. This is particularly so in children under three years of age. Propofol is not recommended for induction of anaesthesia in children under one month of age or for maintenance of anaesthesia in children under three years old.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      19.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Basic Cellular Physiology (0/1) 0%
Physiology (3/10) 30%
Gastrointestinal (1/1) 100%
Cardiovascular (0/4) 0%
Pharmacology (3/9) 33%
Cardiovascular Pharmacology (0/2) 0%
Infections (0/1) 0%
Haematology (2/3) 67%
Pathology (2/3) 67%
Microbiology (0/2) 0%
Principles Of Microbiology (0/1) 0%
Renal (1/2) 50%
Pathogens (0/1) 0%
Cardiovascular Physiology (0/1) 0%
Abdomen (1/1) 100%
Anatomy (1/5) 20%
Upper Limb (0/1) 0%
Respiratory Pharmacology (1/1) 100%
Lower Limb (0/3) 0%
CNS Pharmacology (2/2) 100%
Endocrine (0/2) 0%
Gastrointestinal Physiology (1/1) 100%
Evidence Based Medicine (0/1) 0%
Statistics (0/1) 0%
Anaesthesia (0/1) 0%
Passmed