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Question 1
Correct
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Superficial fibular nerve palsy results in which of the following clinical features:
Your Answer: Loss of eversion of the foot
Explanation:Damage to the superficial fibular nerve results in loss of eversion of the foot and loss of sensation over the lower anterolateral leg and the dorsum of the foot.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 2
Correct
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Which of the following is NOT an adverse effect associated with warfarin therapy:
Your Answer: Neutropenia
Explanation:Adverse effects of warfarin:The most common adverse effect of warfarin is bleedingOther common adverse effects of warfarin include nausea, vomiting, diarrhoea, jaundice, hepatic dysfunction, pancreatitis, pyrexia, alopecia, purpura, and rashSkin necrosis is a rare but serious adverse effect of warfarin; treatment with warfarin should be stopped if warfarin related skin necrosis is suspectedCalciphylaxis is a rare, but a very serious condition that causes vascular calcification and cutaneous necrosis
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 3
Correct
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You examine a 34-year-old lady with symptoms that are consistent with acute sinusitis. You're thinking about giving her doxycycline for treatment.What is doxycycline's mechanism of action?
Your Answer: Inhibition of protein synthesis
Explanation:Doxycycline and other tetracycline antibiotics attach to the 30S subunit of the bacterial ribosome, preventing aminoacyl-tRNA binding and so protein synthesis beginning.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 4
Correct
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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: 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).
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 5
Incorrect
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Which of the following clinical features is most suggestive of a lesion of the frontal lobe:
Your Answer: Receptive dysphasia
Correct Answer: Conjugate eye deviation towards the side of the lesion
Explanation:Conjugate eye deviation towards the side of the lesion is seen in damage to the frontal eye field of the frontal lobe. Homonymous hemianopia is typically a result of damage to the occipital lobe (or of the optic radiation passing through the parietal and temporal lobes). Auditory agnosia may been seen in a lesion of the temporal lobe. Hemispatial neglect may be seen in a lesion of the parietal lobe. Receptive dysphasia is seen in damage to Wernicke’s area, in the temporal lobe.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 6
Incorrect
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A young boy is carried by his friends to the Emergency Department in an unconscious state. He is quickly moved into the resuscitation room. He was at a party with friends and has injected heroin. On examination, his GCS is 6/15, and he has bilateral pinpoint pupils and a very low respiratory rate of 6 breaths per minute. Which of the following is the first-line treatment for this patient?
Your Answer: Naloxone 2 mg IV
Correct Answer: Naloxone 0.8 mg IV
Explanation:Heroin is injected into the veins and is the most commonly abused drug. Acute intoxication with opioid overuse is the most common cause of death by drug overdose. The clinical features of opioid overdose are:1. Decreased respiratory rate2. Reduced conscious level or coma3. Decreased bowel sounds4. Miotic (constricted) pupils5. Cyanosis6. Hypotension7. Seizures8. Non-cardiogenic pulmonary oedema (with IV heroin usage)The main cause of death secondary to opioid overdose is respiratory depression, which usually occurs within 1 hour of the overdose. Vomiting is also common, and aspiration can occur.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 with repeated injections is 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.
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 7
Incorrect
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On review of a patient's serum and urine osmolality test result, you note that both osmolarities are decreased. There urine osmolality does not increase with fluid ingestion.What is the most likely cause?
Your Answer: Syndrome of inappropriate antidiuresis
Correct Answer: Hyponatraemia
Explanation:As part of the investigation of hyponatraemia, serum osmolality is commonly requested in combination with urine osmolality to aid diagnosis.When: Serum osmolality is decreased and urine osmolality is decreased with no intake of fluid, the causes areHyponatraemiaOverhydrationAdrenocortical insufficiencySodium loss (diuretic or a low-salt diet)Serum osmolality is normal or increased and urine osmolality is increased the causes include:DehydrationHyperkalaemiaHyperglycaemiaHyponatremiaMannitol therapyDiabetes mellitusAlcohol ingestionCongestive heart failureRenal disease and uraemiaSerum osmolality is normal or increased and urine osmolality is decreased the usual cause is diabetes insipidusSerum osmolality is decreased and urine osmolality is increased the usual cause is syndrome of inappropriate antidiuresis (SIAD)
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This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 8
Correct
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The term cardiac output refers to the amount of blood pumped by the heart in one minute. The rate in women is around 5 L/min, whereas in men is somewhat higher, around 5.5 L/min.Which of the equations below best describes cardiac output?
Your Answer: Stroke volume x heart rate
Explanation: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.
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This question is part of the following fields:
- Cardiovascular Physiology
- Physiology
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Question 9
Incorrect
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Which of the following clinical features is NOT typical of a facial nerve palsy:
Your Answer: Reduced lacrimal fluid production
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.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 10
Incorrect
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After returning from Thailand two days ago, a 61-year-old man presents to the department with severe diarrhoea and vomiting. He has a history of hypertension and takes an ACE inhibitor to treat it.Which of the following statements about angiotensin-converting enzyme inhibitors is correct?
Your Answer: They commonly cause hypokalaemia
Correct Answer: They have been shown to reduce mortality in heart failure
Explanation:Angiotensin-converting enzyme (ACE) inhibitors prevent angiotensin I from being converted to angiotensin II. Angiotensin II has a variety of effects:Sympathetic activity has increased.Vasoconstriction in the arteriesSecretion of VasopressinSecretion of aldosteroneThe increase in systemic blood pressure is caused by arteriolar vasoconstriction. Vasopressin stimulates water reabsorption in the kidneys as well as the thirst sensation. In the distal convoluted tubules and collecting ducts, aldosterone causes the reabsorption of sodium and water from the urine in exchange for potassium secretion. As a result, ACE inhibitors lower systemic blood pressure while also causing hyperkalaemia.Angiotensin-converting enzyme inhibitors (ACE inhibitors) are used in a variety of clinical settings, including heart failure. According to a meta-analysis, ACE inhibitors reduce death, MI, and overall admission in patients with heart failure by 28%.ACE inhibitors are also used in the following clinical settings:HypertensionChronic kidney diseaseDiabetic nephropathy Following a myocardial infarctionIn the presence of renal artery stenosis, ACE inhibitors are contraindicated because they can cause or exacerbate renal failure.The most common side effect of ACE inhibitors is a dry cough caused by increased bradykinin production. There is, however, no known link to fibrosis of the lungs.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 11
Correct
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Which of the following is NOT a typical feature of a lesion to the vestibulocochlear nerve:
Your Answer: Hyperacusis
Explanation:Hyperacusis is increased acuity of hearing with hypersensitivity to low tones resulting from paralysis of the stapedius muscle, innervated by the facial nerve. General sensation to the face and to the anterior two-thirds of the tongue is carried by the divisions of the trigeminal nerve (although taste to the anterior two-thirds of the tongue is supplied by the facial nerve). Eye movements are mediated by the oculomotor, trochlear and abducens nerve. Ptosis results from paralysis of the levator palpebrae superioris, innervated by the oculomotor nerve, or the superior tarsal muscle, innervated by the sympathetic chain.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 12
Incorrect
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When the breast cancer of a 60-year old patient metastasizes and compresses the intervertebral foramina between the fourth and fifth cervical vertebrae, as well as the fourth and fifth thoracic vertebrae, this causes back pain. Which pair of nerves is most likely affected?
Your Answer: Fourth cervical and fifth thoracic nerves
Correct Answer: Fifth cervical and fourth thoracic nerves
Explanation:The fifth cervical nerve passes between the fourth and fifth cervical vertebrae, and the fourth thoracic nerve passes between the fourth and fifth thoracic vertebrae. Therefore, when the cancer metastasizes in this area, they are most likely affected.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 13
Correct
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Which among the following antibacterial regimens is considered the most appropriate to prescribe in a patient presenting with clinical signs and symptoms consistent with a diagnosis of pelvic inflammatory disease?
Your Answer: Ceftriaxone plus doxycycline plus metronidazole
Explanation:The endocervix is the most common site of Neisseria gonorrhoeae infection in women. Symptoms of infection, when present, include dysuria, cervical discharge, and lower abdominal pain. However, 50% of cases in women may be asymptomatic leading to complications such as pelvic inflammatory disease (PID), which may cause sterility, ectopic pregnancy, or perihepatitis.PID is also known as Fitz-Hugh-Curtis syndrome is defined as an inflammation of the upper genital tract due to an infection in women. The disease affects the uterus, fallopian tubes, and ovaries. It is typically an ascending infection, spreading from the lower genital tract. The recommended intramuscular or oral regimens for PID are as follows:Ceftriaxone at 500 mg IM in a single dose (for persons weighing ≥150 kg, administer 1 g of ceftriaxone); plus doxycycline at 100 mg PO BID for 14 days with metronidazole at 500 mg PO BID for 14 days.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 14
Incorrect
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An injury to the brachial plexus can cause Erb's palsy. The following is expected to happen to a patient suffering from this condition, except for which one:
Your Answer:
Correct Answer: Weakness of medial rotation of the arm
Explanation:Erb’s palsy can be caused by a traumatic force downward on the upper arm and shoulder that damages the upper root of the brachial plexus. The patient will lose shoulder abduction (deltoid, supraspinatus), shoulder external rotation (infraspinatus), and elbow flexion as a result of this condition (biceps, brachialis).
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 15
Incorrect
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Clostridium difficile primarily causes which of the following infectious diseases:
Your Answer:
Correct Answer: Pseudomembranous colitis
Explanation:Clostridium difficile causes pseudomembranous colitis, an acute inflammatory diarrhoeal disease and an important cause of morbidity and mortality in hospitals. Gas gangrene is primarily caused by Clostridium perfringens. Tetanus is caused by Clostridium tetani. Toxic shock syndrome may be caused by Staphylococcus aureus or Streptococcus pyogenes. Necrotising fasciitis is most commonly caused by Streptococcus pyogenes but has a multitude of causes.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 16
Incorrect
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A 30-year-old woman with type 1 diabetes mellitus is brought in drowsy and confused. Her BM is 2.2 mmol/l and a dose of IM glucagon is administered.What is the principal stimulus for the secretion of glucagon?
Your Answer:
Correct Answer: Hypoglycaemia
Explanation:Glucagon, a peptide hormone, is produced and secreted by alpha cells of the islets of Langerhans, located in the endocrine portion of the pancreas. Its main physiological role is stimulation of hepatic glucose output leading to increase in blood glucose. It is the major counter-regulatory hormone to insulin in maintaining glucose homeostasis.The principal stimulus for the secretion of glucagon is hypoglycaemia. Hypoglycaemia then stimulates:GlycogenolysisGluconeogenesisLipolysis in adipose tissue leading to increased glycaemia.Secretion of glucagon is also stimulated by arginine, alanine, adrenaline, acetylcholine and cholecystokininSecretion of glucagon is inhibited by:InsulinSomatostatinIncreased free fatty acidsIncreased urea production
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This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 17
Incorrect
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Thiopental sodium is contraindicated in which of the following:
Your Answer:
Correct Answer: Acute intermittent porphyrias
Explanation:Barbiturates induce hepatic enzymes. The enzyme gamma aminolevulinic acid synthetase, which produces porphyrins, can be induced and in susceptible patients an attack of acute intermittent porphyria can occur. Thiopental is absolutely contraindicated in these patients.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 18
Incorrect
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Which of the following globin chains makes up normal adult haemoglobin (HbA)?
Your Answer:
Correct Answer: Two alpha and two beta chains
Explanation:Total adult haemoglobin comprises about 96 – 98 % of normal adult haemoglobin (HbA). It consists of two alpha (α) and two beta (β) globin chains.
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This question is part of the following fields:
- Basic Cellular
- Physiology
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Question 19
Incorrect
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Which of the following is NOT typically associated with eosinophilia:
Your Answer:
Correct Answer: Whooping cough
Explanation:An eosinophil leucocytosis is defined as an increase in blood eosinophils above 0.4 x 109/L.It is most frequently due to:Allergic diseases (e.g. bronchial asthma, hay fever, atopic dermatitis, urticaria)Parasites (e.g. hookworm, ascariasis, tapeworm, schistosomiasis)Skin diseases (e.g. psoriasis, pemphigus, urticaria, angioedema)Drug sensitivity
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 20
Incorrect
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Bile acids are essential for the digestion and absorption of which of the following:
Your Answer:
Correct Answer: Lipids and fat-soluble vitamins
Explanation:Bile acids are synthesised from cholesterol by hepatocyte and excreted into bile. Bile acids are essential for lipid digestion and absorption. Of the bile acids excreted into the intestine, about 95% are reabsorbed into the portal circulation by active transport mechanisms in the distal ileum and recycled by the liver. Many of the bile salts are reabsorbed unaltered, some are converted by intestinal bacteria into secondary bile acids (deoxycholic acid and lithocholic acid) and then reabsorbed and a small proportion escapes reabsorption and is excreted in the faeces.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 21
Incorrect
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A patient with diplopia is found to have eye deviation downwards and outwards. The likely nerves that are affected are:
Your Answer:
Correct Answer: Oculomotor nerve
Explanation:The results of an oculomotor (CN III) nerve palsy are a depressed and abducted (down and out) eye, ptosis, diplopia, and a fixed and dilated pupil.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 22
Incorrect
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You are treating a patient with a Clostridium difficile infection. His condition was found to be antibiotic-associated. Which of the following pieces of advice on preventing the spread of this disease should you give this patient?
Your Answer:
Correct Answer: Washing hands with soap and water
Explanation:Clostridium difficile (C. diff) can cause colitis, or inflammation of the colon. To prevent its spread, one should practice good hand hygiene, regularly clean areas of the home that may become contaminated with C. difficile, practice good hand hygiene, and clean surfaces, spills, and accidents.
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This question is part of the following fields:
- Microbiology
- Principles
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Question 23
Incorrect
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Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT for:
Your Answer:
Correct Answer: Hepatitis A
Explanation:Disease specific immunoglobulins are available for:hepatitis Brabiestetanusvaricella-zosterNormal immunoglobulin can be used to confer protection against hepatitis A.
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This question is part of the following fields:
- Immunoglobulins And Vaccines
- Pharmacology
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Question 24
Incorrect
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Normal human immunoglobulin is mostly used to protect against which of the following infectious diseases?
Your Answer:
Correct Answer: Measles and hepatitis A
Explanation:Immune globulin IM is indicated for prophylaxis following exposureto hepatitis A, to prevent or modify measles (rubeola) in a susceptible person exposed fewer than 6 days previously,for susceptible household contacts of measles patients,particularly contacts <1 year and pregnant women without evidence of immunity, and to modify rubella in exposed pregnant women who will not consider a therapeutic abortion.
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This question is part of the following fields:
- Immunoglobulins And Vaccines
- Pharmacology
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Question 25
Incorrect
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A patient presents to ED with heartburn for which they already take regular antacids. Which of the following drugs can be affected if taken with antacids:
Your Answer:
Correct Answer: Digoxin
Explanation:Antacids should preferably not be taken at the same time as other drugs since they may affect absorption. When antacids are taken with acidic drugs (e.g. digoxin, phenytoin, chlorpromazine, isoniazid) they cause the absorption of the acidic drugs to be decreased, which causes low blood concentrations of the drugs, which ultimately results in reduced effects of the drugs. Antacids taken with drugs such as pseudoephedrine and levodopa increase absorption of the drugs and can cause toxicity/adverse events due to increased blood levels of the drugs. Antacids that contain magnesium trisilicate and magnesium hydroxide when taken with some other medications (such as tetracycline) will bind to the drugs, and reduce their absorption and effects.
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This question is part of the following fields:
- Gastrointestinal
- Pharmacology
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Question 26
Incorrect
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A newborn baby is rushed to the neonatal ICU 4 hours after birth due to sudden onset severe jaundice and generalised oedema. Family history reveals that this is the second baby, while blood testing shows that the mother has an Rh-negative blood group while the baby is Rh-positive. A diagnosis of haemolytic disease of the newborn is established. Which one of the following hypersensitivity reactions have occurred in this case?
Your Answer:
Correct Answer: Type II hypersensitivity reaction
Explanation:Hepatitis A usually doesn’t pose a special risk to a pregnant woman or her baby. Maternal infection doesn’t result in birth defects, and a mother typically doesn’t transmit the infection to her baby. HAV is almost always transmitted by the faecal-oral route and is usually acquired through close personal contact or via contaminated food.When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes scars, defects of muscle and bone, malformed and paralyzed limbs, small head size, blindness, seizures, and intellectual disability.TORCH Syndrome refers to infection of a developing foetus or newborn by any of a group of infectious agents. “TORCH” is an acronym meaning (T)oxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex.Infection with any of these agents may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and other symptoms and findings.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 27
Incorrect
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Following a phone call from the microbiology consultant, you evaluate a patient who has been diagnosed with urinary sepsis. Following the results of the blood cultures, he recommends that you add gentamicin to the patient's antibiotic treatment.Gentamicin produces its pharmacological effect by binding to which of the following?
Your Answer:
Correct Answer: The 30S subunit of the bacterial ribosome
Explanation:Antibiotics with aminoglycosides, such as gentamicin, bind to the 30S subunit of the bacterial ribosome and prevent aminoacyl-tRNA from binding, preventing protein synthesis.They also cause mRNA misreading, resulting in the production of non-functional proteins. This last mechanism is unique to aminoglycosides, and it may explain why they are bactericidal rather than bacteriostatic, as other protein synthesis inhibitors are.Patients with myasthenia gravis should avoid aminoglycosides since they can disrupt neuromuscular transmission. They cross the placenta and are linked to poisoning of the 8th cranial nerve in the foetus, as well as permanent bilateral deafness.It is possible that they will cause deafness, although this is not a contraindication. In individuals with renal impairment, serum aminoglycoside concentrations should be closely monitored, but this is still not considered a contraindication.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 28
Incorrect
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Cardiac muscle and skeletal muscle are alike, but there are a few key variations. Which of the following is NOT a characteristic of skeletal muscle but is a characteristic of cardiac muscle?
Your Answer:
Correct Answer: The presence of intercalated discs
Explanation:Cardiac muscle is striated, and the sarcomere is the contractile unit, similar to skeletal muscle. Contracture is mediated by the interaction of calcium, troponins, and myofilaments, much as it occurs in skeletal muscle. Cardiac muscle, on the other hand, differs from skeletal muscle in a number of ways.In contrast to skeletal muscle cells, cardiac myocytes have a nucleus in the middle of the cell and sometimes two nuclei. The cells are striated because the thick and thin filaments are arranged in an orderly fashion, although the arrangement is less well-organized than in skeletal muscle.Intercalated discs, which work similarly to the Z band in skeletal muscle in defining where one cardiac muscle cell joins the next, are a very significant component of cardiac muscle.Adherens junctions and desmosomes, which are specialized structures that hold the cardiac myocytes together, are formed by the transverse sections. The lateral sections produce gap junctions, which join the cytoplasm of two cells directly, allowing for rapid action potential conduction. These critical properties allow the heart to contract in a coordinated manner, allowing for more efficient blood pumping.Cardiac myocytes have the ability to create their own action potentials, which is referred to as myogenic’. They can depolarize spontaneously to initiate a cardiac action potential. Pacemaker cells, as well as the sino-atrial (SA) and atrioventricular (AV) nodes, control this.The Purkinje cells and the cells of the bundle of His are likewise capable of spontaneous depolarization. While the bundle of His is made up of specialized myocytes, it’s vital to remember that Purkinje cells are not myocytes and have distinct characteristics. They are larger than myocytes, with fewer filaments and more gap junctions than myocytes. They conduct action potentials more quickly, allowing the ventricles to contract synchronously.Cardiac myocytes contract by excitation-contraction coupling, just like skeletal myocytes. Heart myocytes, on the other hand, utilise a calcium-induced calcium release mechanism that is unique to cardiac muscle (CICR). The influx of calcium ions (Ca2+) into the cell causes a ‘calcium spark,’ which causes more ions to be released into the cytoplasm.An influx of sodium ions induces an initial depolarisation, much as it does in skeletal muscle; however, in cardiac muscle, the inflow of Ca2+ sustains the depolarisation, allowing it to remain longer. Due to potassium ion (K+) inflow, CICR causes a plateau phase in which the cells remain depolarized for a short time before repolarizing. Skeletal muscle, on the other hand, repolarizes almost instantly.Comparison of skeletal and cardiac muscle:Skeletal muscle Cardiac muscleStriation Striated but arrangement less organised Multiple nuclei located peripherally Usually single nucleus (but can be two), located centrallyDiscs None Intercalated discsNo Gap junctions Gap junctions No Pacemaker PacemakerElectrical stimulation: Nervous system (excitation) Pacemaker (excitation)
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This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 29
Incorrect
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A 50-year-old woman has an anaphylactic reaction following accidental ingestion peanuts at a restaurant. She is a known hypertensive on atenolol 50 mg daily and BP is well controlled. She is also on amlodipine 5 mg daily. Two doses of IM adrenaline has been given without improvement.Which medication may prove helpful in this patient?
Your Answer:
Correct Answer: IM Glucagon
Explanation:Resistant to the effects of adrenaline in anaphylaxis is seen in patients taking beta-blockers.Glucagon can be used to overcome the effects of the beta-blockade if initial doses of adrenaline are unsuccessful in patients taking beta-blockers.
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This question is part of the following fields:
- Pharmacology
- Respiratory Pharmacology
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Question 30
Incorrect
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You received a patient with a 2-day history of diarrhoea and vomiting. Later, after examination, the patient was found to have progressive symmetric descending flaccid paralysis, initial development of blurred vision, dysphagia, and weakness of the upper limbs. The patient is apyrexial and his observations are all normal. Which of the following pathogens is responsible for the said symptoms?
Your Answer:
Correct Answer: Clostridium botulinum
Explanation:A botulism infection results in neuroparalysis caused by the neurotoxin generated by Clostridium botulinum. Food-borne botulism symptoms often appear 12-36 hours after ingestion of the toxin-containing food and may include nausea, vomiting, stomach discomfort, and diarrhoea at first. The most common neurological pattern is an acute onset of bilateral cranial neuropathies with symmetric declining weakening. Other distinguishing characteristics include the absence of fever, the absence of cognitive abnormalities, the presence of a normal heart rate and blood pressure, and the absence of sensory defects.
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This question is part of the following fields:
- Microbiology
- Pathogens
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SESSION STATS - PERFORMANCE PER SPECIALTY
