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  • Question 1 - Where does carbohydrate digestion begin: ...

    Correct

    • Where does carbohydrate digestion begin:

      Your Answer: Mouth

      Explanation:

      Carbohydrate digestion begins in the mouth, by alpha-amylase produced in saliva.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      19.6
      Seconds
  • Question 2 - Which of the following clinical features is NOT typical of a facial nerve...

    Incorrect

    • Which of the following clinical features is NOT typical of a facial nerve palsy:

      Your Answer: Hyperacusis

      Correct Answer: Inability to raise the eyelid

      Explanation:

      Facial nerve palsy can result in inability to close the eye due to paralysis of the orbicularis oculi muscle. Elevation of the eyelid in eye opening is a function of the levator palpebrae superioris muscle and the superior tarsal muscle, innervated by the oculomotor nerve and the sympathetic chain respectively.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      29.4
      Seconds
  • Question 3 - You see a 63-year-old man with a history of melaena and epigastric discomfort....

    Incorrect

    • You see a 63-year-old man with a history of melaena and epigastric discomfort. For a few months, he's been taking aspirin.Which of the following statements about aspirin's mechanism of action is correct?

      Your Answer: COX-1 inhibition is primarily responsible for its anti-inflammatory effects

      Correct Answer: It inhibits both COX-1 and COX-2 at medium to high doses (500-5000 mg per day)

      Explanation:

      Aspirin inhibits cyclo-oxygenase irreversibly by covalently acetylating the cyclo-oxygenase active site in both COX-1 and COX-2. The production of prostaglandin and thromboxane is reduced as a result. As a result, platelet activation and aggregation are reduced. A single dose of aspirin has a half-life of 7-10 days, which is the time it takes for the bone marrow to produce new platelets.Aspirin only inhibits COX-1, the enzyme that produces thromboxane A2, at low doses (75 mg per day), and thus has a primarily anti-thrombotic effect.Aspirin inhibits both COX-1 and COX-2 at medium to high doses (500-5000 mg per day). COX-2 is involved in the production of prostaglandins, so it has an anti-inflammatory effect at these concentrations.Aspirin, when used as an antipyretic for a viral illness in children, can cause Reye’s syndrome. Reye’s syndrome is a potentially fatal liver disease that causes encephalopathy and liver failure.The inability of aspirin to reduce platelet production of thromboxane A2, and thus platelet activation and aggregation, is known as aspirin resistance. Although the exact frequency and mechanism of aspirin resistance are unknown, it is thought to affect about 1% of users. Women are more likely than men to experience this phenomenon.According to new research, taking aspirin on a regular basis lowers the risk of colorectal cancer. It may also protect against cancers of the breast, bladder, prostate, and lungs.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      49.9
      Seconds
  • Question 4 - Which of the following side effects would you least associated with ciprofloxacin: ...

    Correct

    • Which of the following side effects would you least associated with ciprofloxacin:

      Your Answer: Folate deficiency

      Explanation:

      Common side effects include diarrhoea, dizziness, headache, nausea and vomiting.Other adverse effects include: Tendon damage (including rupture), Seizures (in patients with and without epilepsy), QT-interval prolongation, Photosensitivity and Antibiotic-associated colitis

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      7.2
      Seconds
  • Question 5 - Regarding atracurium, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: Effects such as flushing, tachycardia and hypotension can occur due to significant histamine release.

      Explanation:

      Cardiovascular effects such as flushing, tachycardia, hypotension and bronchospasm are associated with significant histamine release; histamine release can be minimised by administering slowly or in divided doses over at least 1 minute. Atracurium undergoes non-enzymatic metabolism which is independent of liver and kidney function, thus allowing its use in patients with hepatic or renal impairment. Atracurium has no sedative or analgesic effects. All non-depolarising drugs should be used with care in patients suspected to be suffering with myasthenia gravis or myasthenic syndrome, as patients with these conditions are extremely sensitive to their effects and may require a reduction in dose.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      6.5
      Seconds
  • Question 6 - A 20-year-old female presents with painful wrist following a fall while skating. X-rays...

    Correct

    • A 20-year-old female presents with painful wrist following a fall while skating. X-rays shows fracture of the ulna.The initial phase of bone healing is?

      Your Answer: Haematoma at the fracture site

      Explanation:

      Haemorrhage occurs into the fracture site from the ruptured vessels in the bone marrow and those supplying the periosteum immediately after fracture. This hematoma formation is the first phase of bone healing.The 4 stages of bone healing are:Haematoma at the fracture site (provides a framework for healing)Callus formationLamellar bone formationRemodelling

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      22.8
      Seconds
  • Question 7 - A 55-year-old male diabetic patient presents to the Emergency Room complaining of severe...

    Incorrect

    • A 55-year-old male diabetic patient presents to the Emergency Room complaining of severe chest pain. His medical record shows that he had coronary angioplasty one week ago, during which he was administered abciximab. Which of the following haematological diseases has a similar mechanism of action to this drug?

      Your Answer: Von Willebrand disease

      Correct Answer: Glanzmann’s thrombasthenia

      Explanation:

      Abciximab is glycoprotein IIb/IIIa receptor antagonist that decreases aggregation of platelets by prevent their cross-linking. In Glanzmann’s thrombasthenia there are low levels of these same receptors leading to decreased bridging of platelets as fibrinogen cannot attach. There is increased bleeding time both in this disease and when there is use of abciximab.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      13.7
      Seconds
  • Question 8 - Which of the following causes the first heart sound? ...

    Correct

    • Which of the following causes the first heart sound?

      Your Answer: Closing of the atrioventricular valves

      Explanation:

      The heart sounds are as a result of the various parts of the cardiac cycle.Heart Sound – Phase of Cardiac Cycle – Mechanical Event:1st heart sound – Systole starts – there is closure of the atrioventricular (mitral & tricuspid) valves2nd heart sound – Systole ends – there is closure of the semilunar (aortic and pulmonary) valves3rd heart sound – Early diastole – this is caused by rapid flow of blood from the atria into the ventricles during the ventricular filling phase4th heart sound – Late diastole – this is caused by filling of an abnormally stiff ventricle in atrial systole

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      10.7
      Seconds
  • Question 9 - A 65-year-old man comes for a visit at the clinic with complaints of...

    Incorrect

    • A 65-year-old man comes for a visit at the clinic with complaints of abdominal pain. On inquiring about drug history, you find out that he has been taking around 8-10 paracetamol to help relieve the pain. Out of the following, which one is believed to be the main mechanism of action for paracetamol?

      Your Answer: Selective inhibition of COX-1 receptors

      Correct Answer: Selective inhibition of COX-3 receptors

      Explanation:

      The FDA categorizes Paracetamol as an NSAID (nonsteroidal anti-inflammatory drug) as it is believed to selectively inhibit cyclo-oxygenase 3 (COX-3) receptors in the brain and spinal cord. COX-3 is a unique variant of the more known COX-1 and COX-2. It is responsible for the production of prostaglandins in central areas, which sensitizes free nerve endings to the chemical mediators of pain. Therefore, by selectively inhibiting COX-3, paracetamol effectively reduces pain sensation by increasing the pain threshold.Acetaminophen does not inhibit cyclooxygenase in peripheral tissues and, therefore, has no peripheral anti-inflammatory effects.The antipyretic actions of acetaminophen are likely attributed to direct action on heat-regulating centres in the brain, resulting in peripheral vasodilation, sweating, and loss of body heat.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      23.2
      Seconds
  • Question 10 - Which lobe of the prostate gland is most commonly affected in prostatic carcinoma?...

    Correct

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

      Your 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
      6.8
      Seconds
  • Question 11 - A 45-old woman is on several medications and being treated for epilepsy and...

    Incorrect

    • A 45-old woman is on several medications and being treated for epilepsy and bipolar disorder. In the ward rounds, you are asked to examine her in detail and discover she has a noticeable tremor. You believe that one of her medications may be responsible for this new onset tremor. Which of the following medications is least likely to be responsible for this tremor?

      Your Answer: Olanzapine

      Correct Answer: Carbamazepine

      Explanation:

      The only medication that does not commonly cause tremors is carbamazepine.The other drugs present with the following types of tremors as a side effect to their usage:1. Sodium valproate – Postural tremor is most common, but a resting tremor can also occur. Approximately 25% of patients taking sodium valproate are found to develop a tremor within 12 months of starting therapy.2. Lithium – fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer.3. Atypical antipsychotics, such as olanzapine and quetiapine – tremor and limb shakiness.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      22.7
      Seconds
  • Question 12 - Which of the following is NOT mainly characterised by intravascular haemolysis: ...

    Incorrect

    • Which of the following is NOT mainly characterised by intravascular haemolysis:

      Your Answer: Glucose-6-phosphate dehydrogenase deficiency

      Correct Answer: Beta-Thalassaemia

      Explanation:

      Causes of intravascular haemolysis:Haemolytic transfusion reactionsG6PD deficiencyRed cell fragmentation syndromesSome severe autoimmune haemolytic anaemiasSome drug-and infection-induced haemolytic anaemiasParoxysmal nocturnal haemoglobinuria

    • This question is part of the following fields:

      • Haematology
      • Pathology
      33.3
      Seconds
  • Question 13 - A 64-year-old woman with a history of chronic breathlessness is referred for lung...

    Incorrect

    • A 64-year-old woman with a history of chronic breathlessness is referred for lung function testing.Which of the following statements regarding lung function testing is FALSE? Select ONE answer only.

      Your Answer: In obstructive lung disease, FVC is usually reduced but to a lesser extent than FEV 1

      Correct Answer: In restrictive lung disease, the FVC is increased

      Explanation:

      In restrictive lung disorders there is a reduction in the forced vital capacity (FVC) and the forced expiratory volume in one second (FEV1). The decline in the FVC is greater than that of the FEV1, resulting in preservation of the FEV1/FVC ratio (>0.7%).In obstructive lung disease, FEV1is reduced to <80% of normal and FVC is usually reduced but to a lesser extent than FEV1. The FEV1/FVC ratio is reduced to 80% in the presence of symptomsModerate airflow obstruction = FEV1 of 50-79%Severe airflow obstruction = FEV1 of 30-49%Very severe airflow obstruction = FEV1<30%.Spirometry is a poor predictor of durability and quality of life in COPD but can be used as part of the assessment of severity.COPD can only be diagnosed on spirometry if the FEV1 is <80% and FEV1/FVC ratio is < 0.7.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      53.1
      Seconds
  • Question 14 - You are teaching a group of medical students about cardiovascular examination. You are...

    Correct

    • You are teaching a group of medical students about cardiovascular examination. You are discussing heart sounds and the cardiac cycle. Which of the following stages of the cardiac cycle occurs immediately after the aortic valve closes:

      Your Answer: Isovolumetric relaxation

      Explanation:

      Immediately after the closure of the semilunar valves, the ventricles rapidly relax and ventricular pressure decreases rapidly but the AV valves remain closed as initially the ventricular pressure is still greater than atrial pressure. This is isovolumetric relaxation. Atrial pressure continues to rise because of venous return, with the v wave of the JVP waveform peaking during this phase. Rapid flow of blood from the atria into the ventricles during the ventricular filling phase causes thethird heart sound, which is normal in children but, in adults, is associated with disease such as ventricular dilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      38.7
      Seconds
  • Question 15 - Regarding Clostridium difficile, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding Clostridium difficile, which of the following statements is CORRECT:

      Your Answer: It has endotoxin-mediated effects causing profuse watery diarrhoea.

      Correct Answer: It is normally found in gut flora.

      Explanation:

      C. difficile is normally found in the gut flora but its growth is normally suppressed by more dominant anaerobes. It has exotoxin-mediated effects causing profuse diarrhoea. Oral clindamycin (a broad spectrum antibiotic) is commonly implicated in precipitating C. difficile colitis; first line treatment is with oral metronidazole. Tetanolysin is a toxin produced by Clostridium tetani bacteria.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      30.6
      Seconds
  • Question 16 - Due to a traffic accident, a male patient was unable to flex his...

    Correct

    • Due to a traffic accident, a male patient was unable to flex his arm at the glenohumeral joint. Based on the patient’s current condition, which nerve is most likely damaged?

      Your Answer: Axillary and suprascapular nerve

      Explanation:

      A suprascapular nerve injury causes numbness in the shoulder, as well as weakness in abduction and external rotation. Damage to the axillary nerve can result in shoulder or arm muscle weakness, as well as difficulty lifting the arm. This is because the deltoid and supraspinatus muscles, which are innervated by the axillary and suprascapular nerves, are responsible for abduction of the arm at the shoulder joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.9
      Seconds
  • Question 17 - Regarding the refractory period, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding the refractory period, which of the following statements is INCORRECT:

      Your Answer: The absolute refractory period is due to the inactivation of Na + channels.

      Correct Answer: Action potentials can occur in the relative refractory period but the amplitude of the action potential is smaller.

      Explanation:

      Following the action potential, Na+channels remain inactive for a time in a period known as the absolute refractory period where they cannot be opened by any amount of depolarisation. Following this there is a relative refractory period where the temporary hyperpolarisation (due to delayed closure of rectifier K+channels) makes the cell more difficult to depolarise and an action potential can be generated only in response to a larger than normal stimulus. The refractory period limits the frequency at which action potentials can be generated, and ensures that, once initiated, an action potential can travel only in one direction. An action potential is an all or nothing response so the amplitude of the action potential cannot be smaller.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      25.1
      Seconds
  • Question 18 - The movement of molecules across the cell membrane relies greatly on active transport.Which of...

    Incorrect

    • The movement of molecules across the cell membrane relies greatly on active transport.Which of the following statements about active transport is correct?

      Your Answer: Primary active transport involves the use of an electrochemical gradient

      Correct Answer: Active transport occurs in glucose absorption from the gut

      Explanation:

      The movement of a material against a concentration gradient, i.e. from a low to a high concentration, is known as active transport. Primary active transport is defined as active transport that involves the use of chemical energy, such as adenosine triphosphate (ATP). Secondary active transport occurs when an electrochemical gradient is used.The sodium-potassium pump, calcium ATPase pump, and proton pump are all key active transport systems that use ATP. An electrochemical gradient is used by the sodium-calcium co-transporter, which is an example of secondary active transport.The sodium-dependent hexose transporter SGLUT-1 transports glucose and galactose into enterocytes. Secondary active transport is exemplified here.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      29.5
      Seconds
  • Question 19 - A patient suffers from an injury to his hip and thigh. As a...

    Correct

    • A patient suffers from an injury to his hip and thigh. As a consequence of his injury, the nerve that was damaged innervates the obturator externus muscle.In which of the following nerves is the obturator externus muscle innervated by?

      Your Answer: Posterior branch of the obturator nerve

      Explanation:

      The obturator externus is innervated by the posterior branch of the obturator nerve, L2-L4.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      33.3
      Seconds
  • Question 20 - Aplastic crises in sickle cell anaemia is classically precipitated by which of the...

    Incorrect

    • Aplastic crises in sickle cell anaemia is classically precipitated by which of the following infections:

      Your Answer: Epstein-Barr virus

      Correct Answer: Parvovirus B19

      Explanation:

      A serious complication in sickle cell disease (SCD) is the aplastic crisis. This may be caused by infection with Parvovirus B-19 (B19V). This virus causes fifth disease, a normally benign childhood disorder associated with fever, malaise, and a mild rash. This virus infects RBC progenitors in bone marrow, resulting in impaired cell division for a few days. Healthy people experience, at most, a slight drop in hematocrit, since the half-life of normal erythrocytes in the circulation is 40-60 days. In people with SCD, however, the RBC lifespan is greatly shortened (usually 10-20 days), and a very rapid drop in Hb occurs. The condition is self-limited, with bone marrow recovery occurring in 7-10 days, followed by brisk reticulocytosis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      18.6
      Seconds
  • Question 21 - A patient who shows symptoms of infection and is admitted under supervision of...

    Correct

    • A patient who shows symptoms of infection and is admitted under supervision of the medical team. The organism which caused this, is a Gram-negative bacterium, according to the culture. A penicillin therapy is suggested by the microbiologist.Which of the penicillins listed below is the most effective against Gram-negative bacteria? 

      Your Answer: Amoxicillin

      Explanation:

      Amoxicillin and Ampicillin are more hydrophilic (broad-spectrum) penicillins than benzylpenicillin and phenoxymethylpenicillin. Because they may penetrate through gaps in the outer phospholipid membrane, they are effective against Gram-negative bacteria. Amoxicillin and Ampicillin are resistant to penicillinase-producing microbes.Community-acquired pneumonia, otitis media, sinusitis, oral infections, and urinary tract infections are among the most prevalent conditions for which they are prescribed. The normal adult oral dose of Amoxicillin is 500 mg three times/day, which can be increased to 1 g three times/day if necessary. Ampicillin is given to adults in doses of 0.5-1 g every 6 hours.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      22.2
      Seconds
  • Question 22 - Where: Capillary hydrostatic pressure is (P c) Hydrostatic pressure in the interstices is (P I...

    Incorrect

    • Where: Capillary hydrostatic pressure is (P c) Hydrostatic pressure in the interstices is (P I )Plasma oncotic pressure is (π p) Interstitial oncotic pressure is (π i)Which of the following formulas best represents fluid flow at the capillary bed?

      Your Answer: Volume / min = (P c - P i ) - (π i - π p )

      Correct Answer: Volume / min = (P c - P i ) - (π p - π i )

      Explanation:

      Starling’s equation for fluid filtration describes fluid flow at the capillary bed.Filtration forces (capillary hydrostatic pressure and interstitial oncotic pressure) stimulate fluid movement out of the capillary, while resorption forces promote fluid movement into the capillary (interstitial hydrostatic pressure and plasma oncotic pressure). Although the forces fluctuate along the length of the capillary bed, overall filtration is achieved.At the capillary bed, there is fluid movement.The reflection coefficient (σ), the surface area accessible (S), and the hydraulic conductance of the wall (Lp) are frequently used to account for the endothelium’s semi-permeability, yielding:Volume / min = LpS [(Pc- Pi) –  σ(πp– πi)]Volume /min = (Pc-Pi) – (πp–πi) describes the fluid circulation at the capillaries.Where:Pc= capillary hydrostatic pressurePi= interstitial hydrostatic pressureπp= plasma oncotic pressureπi= interstitial oncotic pressure

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      24.1
      Seconds
  • Question 23 - Regarding the abductor pollicis longus, which of the following statements is true? ...

    Incorrect

    • Regarding the abductor pollicis longus, which of the following statements is true?

      Your Answer: It arises from the lateral epicondyle of the elbow

      Correct Answer: It extends the thumb at the carpometacarpal joint

      Explanation:

      Abductor pollicis longus is a muscle found in the posterior compartment of the forearm. It is one of the five deep extensors in the forearm, along with the supinator, extensor pollicis brevis, extensor pollicis longus and extensor indicis.Abductor pollicis longus is innervated by the posterior interosseous nerve (C7, C8), which is a continuation of the deep branch of the radial nerve. The radial nerve is a branch of the posterior cord of the brachial plexus.Blood supply to the abductor pollicis longus muscle comes from the interosseous branches of the ulnar artery.Acting alone or with abductor pollicis brevis, abductor pollicis longus pulls the thumb away from the palm. More specifically, it produces (mid-) extension and abduction of the thumb at the first metacarpophalangeal joint. This action is seen in activities such as bowling and shovelling.Working together with the long and short extensors of the thumb, the muscle also helps to fully extend the thumb at the metacarpophalangeal joint. This action is important for loosening the hand grip, for example, when letting go of objects previously being held. Abductor pollicis longus also helps to abduct the hand (radial deviation) at the radiocarpal joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      21.1
      Seconds
  • Question 24 - All of the following statement are correct regarding endothelium derived nitric oxide except:...

    Incorrect

    • All of the following statement are correct regarding endothelium derived nitric oxide except:

      Your Answer: Nitric oxide inhibits platelet activation and thrombosis.

      Correct Answer: Nitric oxide production is inhibited by local mediators such as bradykinin, histamine and serotonin.

      Explanation:

      Factors that elevate intracellular Ca2+ increase nitric oxide (NO) production by the endothelium included local mediators such as histamine and serotonin, bradykinin, and some neurotransmitters like substance P. NO production is also stimulated by increased flow (shear stress) and additionally activates prostacyclin synthesis. As a result of basal production of NO, there is continuous modulation of vascular resistance and as a result, there is increased production of nitric oxide acts which causes vasodilation. Platelet activation and thrombosis are inhibited by nitric oxide.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      23.9
      Seconds
  • Question 25 - A patient presents with a rash for dermatological examination. A large area of...

    Incorrect

    • A patient presents with a rash for dermatological examination. A large area of purplish discolouration of the skin that measures 2 cm in diameter and does not blanch when pressure is applied is seen .What is the best description of this rash that you have found on examination?

      Your Answer: Macule

      Correct Answer: Ecchymoses

      Explanation:

      Ecchymosis are discolouration of the skin or mucous membranes caused by extravasation of blood. They are usually red or purple in colour and measure greater than 1 cm in diameter and do not blanch on applying pressure. 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. Petechiae are discolouration of the skin measuring less than 3 mm in diameterPurpura are discolouration of the skin measuring between 0.3 cm and 1 cm in diameter.Erythema is redness of the skin or mucous membranes caused by hyperaemia of superficial capillaries caused by skin injury, infection or inflammation. Erythema blanches when pressure is applied whereas ecchymosis, purpura and petechiae do not.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      24.2
      Seconds
  • Question 26 - Which of the following is NOT a typical effect of cortisol: ...

    Incorrect

    • Which of the following is NOT a typical effect of cortisol:

      Your Answer: Immunosuppression

      Correct Answer: Decreased protein catabolism

      Explanation:

      Cortisol is a steroid hormone produced in the zona fasciculata of the adrenal cortex. It is released in response to stress and low blood glucose concentrations.Cortisol acts to: raise plasma glucose by stimulating glycolysis and gluconeogenesis in the liver and inhibiting peripheral glucose uptake into storage tissues, increase protein breakdown in skeletal muscle, skin and bone to release amino acids, increase lipolysis from adipose tissues to release fatty acidsand at higher levels and mimic the actions of aldosterone on the kidney to retain Na+ and water and lose K+ ionssuppress the action of immune cells

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      30.3
      Seconds
  • Question 27 - A 29 year old man presents to ED followed an alleged assault whilst...

    Incorrect

    • A 29 year old man presents to ED followed an alleged assault whilst out drinking. He received blunt trauma to his right axilla. He is complaining of difficulty abducting his right arm above the level of his shoulder, and on inspection, the inferior angle of his right scapula protrudes more than that of his left scapula. Which of the following nerves has most likely been affected:

      Your Answer: Dorsal scapular nerve

      Correct Answer: Long thoracic nerve

      Explanation:

      Damage to the long thoracic nerve results in weakness/paralysis of the serratus anterior muscle causing difficulty abducting the upper limb above 90 degrees and giving a ‘winged ‘ scapula appearance where the medial border, particularly the inferior angle, of the scapula moves laterally and posteriorly away from the thoracic wall (this becomes more pronounced if the patient presses the upper limb against a wall).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      20.3
      Seconds
  • Question 28 - A 32-year-old man is dehydrated as he presents with severe vomiting and diarrhoea....

    Incorrect

    • A 32-year-old man is dehydrated as he presents with severe vomiting and diarrhoea. He urgently requires resuscitation with intravenous fluid administration. He is also administered metoclopramide.Which of the following is the true mechanism of action of metoclopramide?

      Your Answer: Neurokinin receptor antagonism

      Correct Answer: Dopamine receptor antagonism

      Explanation:

      Metoclopramide is used to treat nausea and vomiting. It works by blocking the central and peripheral D2 (dopamine 2) receptors in the medullary chemoreceptor trigger zone in the vomiting centre (area postrema). It decreases the sensitivity of the visceral sensory nerves that transmit from the GI system to the vomiting centre. Blockade of inhibitory dopamine receptors in the GI tract may allow stimulatory actions of ACh at muscarinic synapses to predominate.At high doses, metoclopramide also blocks type-2 serotonin receptors though the effect is much weaker.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      25
      Seconds
  • Question 29 - A 64-year-old lady attends the emergency department with a known brain tumour. Her...

    Incorrect

    • A 64-year-old lady attends the emergency department with a known brain tumour. Her left eye is directed outwards and downwards, she can't open it, and her pupil is fixed and dilated. The tumour is most likely compressing which of the following structures:

      Your Answer: Trochlear nerve

      Correct Answer: Oculomotor nerve

      Explanation:

      The oculomotor nerve is the third cranial nerve. It is the main source of innervation to the extraocular muscles and also contains parasympathetic fibres which relay in the ciliary ganglion. Damage to the third cranial nerve may cause diplopia, pupil mydriasis, and/or upper eyelid ptosis. The clinical manifestations of third cranial nerve dysfunction reflect its constituent parts.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      33.6
      Seconds
  • Question 30 - Regarding haemoglobin, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Foetal haemoglobin remains the primary haemoglobin in infants up until about 1 year of age.

      Correct Answer: In degradation of haemoglobin, the haem group is split from the haemoglobin and converted to biliverdin and ultimately to bilirubin.

      Explanation:

      Haemoglobin is composed of four polypeptide globin chains each with its own iron containing haem molecule. Haem synthesis occurs largely in the mitochondria by a series of biochemical reactions commencing with the condensation of glycine and succinyl coenzyme A under the action of the key rate-limiting enzyme delta-aminolevulinic acid (ALA) synthase. The globin chains are synthesised by ribosomes in the cytosol. Haemoglobin synthesis only occurs in immature red blood cells.There are three types of haemoglobin in normal adult blood: haemoglobin A, A2 and F:- Normal adult haemoglobin (HbA) makes up about 96 – 98 % of total adult haemoglobin, and consists of two alpha (α) and two beta (β) globin chains. – Haemoglobin A2 (HbA2), a normal variant of adult haemoglobin, makes up about 1.5 – 3.5 % of total adult haemoglobin and consists of two α and two delta (δ) globin chains.- Foetal haemoglobin is the main Hb in the later two-thirds of foetal life and in the newborn until approximately 12 weeks of age. Foetal haemoglobin has a higher affinity for oxygen than adult haemoglobin. Red cells are destroyed by macrophages in the liver and spleen after , 120 days. The haem group is split from the haemoglobin and converted to biliverdin and then bilirubin. The iron is conserved and recycled to plasma via transferrin or stored in macrophages as ferritin and haemosiderin. An increased rate of haemoglobin breakdown results in excess bilirubin and jaundice.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      21.8
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