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  • Question 1 - Which of these drugs may reduce the efficacy of contraception? ...

    Correct

    • Which of these drugs may reduce the efficacy of contraception?

      Your Answer: Carbamazepine

      Explanation:

      Antiepileptic medications such as carbamazepine (Tegretol), topiramate (Topamax), and phenytoin (Dilantin) are widely known for reducing the contraceptive effectiveness of OCPs.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      25.3
      Seconds

  • Question 2 - Which of the following is first-line for management of status epilepticus: ...

    Correct

    • Which of the following is first-line for management of status epilepticus:

      Your Answer: Intravenous lorazepam

      Explanation:

      First-line treatment is with intravenous lorazepam if available. Intravenous diazepam is effective but it carries a high risk of thrombophlebitis so should only be used if intravenous lorazepam is not immediately available. Absorption of diazepam from intramuscular injection or from suppositories is too slow for treatment of status epilepticus. When facilities for resuscitation are not immediately available or if unable to secure immediate intravenous access, diazepam can be administered as a rectal solution or midazolam oromucosal solution can be given into the buccal cavity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      18.8
      Seconds

  • Question 3 - Which lobe of the prostate gland is most commonly affected in benign prostatic...

    Correct

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

      Your Answer: Median

      Explanation:

      Benign enlargement of the prostate is common in men older than 50 years. The cause is possibly an imbalance in the hormonal control of the gland. The median lobe of the gland enlarges upward and encroaches within the sphincter vesicae, located at the neck of the bladder. The leakage of urine into the prostatic urethra causes an intense reflex desire to micturate. The enlargement of the median and lateral lobes of the gland produces elongation and lateral compression and distortion of the urethra so that the patient experiences difficulty in passing urine and the stream is weak. Back-pressure effects on the ureters and both kidneys are a common complication. The enlargement of the uvula vesicae (owing to the enlarged median lobe) results in the formation of a pouch of stagnant urine behind the urethral orifice within the bladder. The stagnant urine frequently becomes infected, and the inflamed bladder (cystitis) adds to the patient’s symptoms.In all operations on the prostate, the surgeon regards the prostatic venous plexus with respect. The veins have thin walls, are valveless, and are drained by several large trunks directly into the internal iliac veins. Damage to these veins can result in a severe haemorrhage.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      7.9
      Seconds

  • Question 4 - Which coronary artery is mostly likely affected if an ECG shows a tombstone...

    Correct

    • Which coronary artery is mostly likely affected if an ECG shows a tombstone pattern in leads V2, V3 and V4?

      Your Answer: Left anterior descending artery

      Explanation:

      Tombstoning ST elevation myocardial infarction can be described as a STEMI characterized by tombstoning ST-segment elevation. This myocardial infarction is associated with extensive myocardial damage, reduced left ventricle function, serious hospital complications and poor prognosis. Tombstoning ECG pattern is a notion beyond morphological difference and is associated with more serious clinical results.Studies have shown that tombstoning is more commonly found in anterior than non-anterior STEMI, thus, higher rates of left anterior descending artery disease are observed in patients with tombstoning pattern.The following ECG leads determine the location and vessels involved in myocardial infarction:ECG Leads Location Vessel involvedV1-V2 Septal wall Left anterior descendingV3-V4 Anterior wall Left anterior descendingV5-V6 Lateral wall Left circumflex arteryII, III, aVF Inferior wall Right coronary artery (80%) or Left circumflex artery (20%)I, aVL High lateral wall Left circumflex arteryV1, V4R Right ventricle Right coronary arteryV7-V9 Posterior wall Right coronary artery

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      12.6
      Seconds

  • Question 5 - Which of the following is a contraindication to the use of opioid analgesics: ...

    Correct

    • Which of the following is a contraindication to the use of opioid analgesics:

      Your Answer: Raised intracranial pressure

      Explanation:

      Opioids should be avoided in people who have: A risk of paralytic ileus (opioids reduce gastric motility)Acute respiratory depressionAn acute exacerbation of asthma (opioids can aggravate bronchoconstriction as a result of histamine release)Conditions associated with increased intracranial pressure including head injury (opioids can interfere with pupillary response making neurological assessment difficult and may cause retention of carbon dioxide aggravating the increased intracranial pressure)

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      10.2
      Seconds

  • Question 6 - A patient presents with an adducted eye at rest which cannot abduct past...

    Correct

    • A patient presents with an adducted eye at rest which cannot abduct past the midline, which of the following cranial nerves is most likely to be affected:

      Your Answer: Abducens nerve

      Explanation:

      Abducens nerve palsies result in a convergent squint at rest (eye turned inwards) with inability to abduct the eye because of unopposed action of the rectus medialis. The patient complains of horizontal diplopia when looking towards the affected side. With complete paralysis, the eye cannot abduct past the midline.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      22.9
      Seconds

  • Question 7 - The 'pump handle' movement of the thoracic wall describes which of the following movements:...

    Correct

    • The 'pump handle' movement of the thoracic wall describes which of the following movements:

      Your Answer: The anterior ends of the ribs moving upwards and forwards

      Explanation:

      Because the anterior ends of the ribs are inferior to the posterior ends, when the ribs are elevated, the anterior end moves upwards and forwards, moving the sternum upwards and forwards in turn. This ‘pump handle’ upwards and forwards movement changes the anteroposterior (AP) dimension of the thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      22.6
      Seconds

  • Question 8 - The parasympathetic supply to the rectum is from which of the following: ...

    Incorrect

    • The parasympathetic supply to the rectum is from which of the following:

      Your Answer: Superior hypogastric plexus

      Correct Answer: Pelvic splanchnic nerves

      Explanation:

      Parasympathetic supply is from the pelvic splanchnic nerves (S2 – S4) and inferior hypogastric plexus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      13.1
      Seconds

  • Question 9 - A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate,...

    Incorrect

    • A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate, nasal regurgitation of food, and nasal quality to the voice. Which of the following cranial nerves is most likely responsible for the aforementioned features?

      Your Answer: Glossopharyngeal nerve

      Correct Answer: Vagus nerve

      Explanation:

      The vagus nerve, ‘the wanderer’, contains motor fibres (to the palate and vocal cords), sensory components (posterior and floor of external acoustic meatus) and visceral afferent and efferent fibres. Palatal weakness can cause nasal speech and nasal regurgitation of food. The palate moves asymmetrically when the patient says ‘ahh’. Recurrent nerve palsy results in hoarseness, loss of volume and ‘bovine cough’.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      41.2
      Seconds

  • Question 10 - Which of the following is a well recognised adverse effect of prochlorperazine: ...

    Correct

    • Which of the following is a well recognised adverse effect of prochlorperazine:

      Your Answer: Acute dystonic reaction

      Explanation:

      Adverse actions include anticholinergic effects such as drowsiness, dry mouth, and blurred vision, extrapyramidal effects, and postural hypotension. Phenothiazines can all induce acute dystonic reactions such as facial and skeletal muscle spasms and oculogyric crises; children (especially girls, young women, and those under 10 kg) are particularly susceptible.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      13.7
      Seconds

  • Question 11 - All of the following typically occurs as part of normal passive expiration except:...

    Correct

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

      Your Answer: Contraction of the internal intercostal muscles

      Explanation:

      Passive expiration is produced primarily by relaxation of the inspiratory muscles (diaphragm and external intercostal muscles) in addition to the elastic recoil of the lungs. In expiration, several movements occur. There are:1. depression of the sternal ends of the ribs (‘pump handle’ movement), 2. depression of the lateral shafts of the ribs (‘bucket handle’ movement) and 3. elevation of the diaphragm. These result in a reduction of the thorax in an anteroposterior, transverse and vertical direction respectively. There is then a decreased intrathoracic volume and increased intrathoracic pressure and air is forced out of the lungs.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      20.5
      Seconds

  • Question 12 - Which of the following is a contraindication for aspirin? ...

    Correct

    • Which of the following is a contraindication for aspirin?

      Your Answer: Children under 16 years

      Explanation:

      Aspirin contraindications include: hypersensitivity to NSAIDs; asthma, rhinitis, and nasal polyps; and usage in children or teens.There is little evidence of allergic cross-reactivity for salicylates. However, due to similarities in chemical structure and/or pharmacologic activities, the possibility of cross-sensitivity cannot be completely ruled out.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      11.1
      Seconds

  • Question 13 - A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense,...

    Correct

    • A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense, vibratory sense, and discriminatory touch. Upon further physical examination, it was observed that her tongue deviates to the left-hand side. An MRI and CT scan was ordered and results showed that he was suffering a left-sided stroke. Which of the following is considered the best diagnosis for the case presented above?

      Your Answer: Medial medullary syndrome

      Explanation:

      Medial medullary syndrome is a form of stroke that affects the medial medulla of the brain. It is caused by a lesion in the medial part of the medulla, which is due to an infraction of vertebral arteries and/or paramedian branches of the anterior spinal artery.It is characterized by contralateral paralysis of the upper and lower limb of the body, a contralateral decrease in proprioception, vibration, and/or fine touch sensation, paresthesias or less commonly dysesthesias in the contralateral trunk and lower limb, and loss of position and vibration sense with proprioceptive dysfunction. Ipsilateral deviation of the tongue due to ipsilateral hypoglossal nerve damage can also be seen.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      57
      Seconds

  • Question 14 - An 80-year-old woman with history of hypertension, diabetes, and ischemic stroke, presents with...

    Incorrect

    • An 80-year-old woman with history of hypertension, diabetes, and ischemic stroke, presents with left-sided hemiplegia of the face, tongue, and limbs and right-sided deficits in motor eye activity. A CT scan was ordered and showed a right-sided stroke. Branches of which of the following arteries are most likely implicated in the case?

      Your Answer: Vertebral artery

      Correct Answer: Basilar artery

      Explanation:

      Weber syndrome is a midbrain stroke characterized by crossed hemiplegia along with oculomotor nerve deficits and it occurs with the occlusion of the median and/or paramedian perforating branches of the basilar artery. Typical clinical findings include ipsilateral CN III palsy, ptosis, and mydriasis (such as damage to parasympathetic fibres of CN III) with contralateral hemiplegia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      30.5
      Seconds

  • Question 15 - Contraction of the diaphragm results in which of the following effects: ...

    Incorrect

    • Contraction of the diaphragm results in which of the following effects:

      Your Answer: Elevation of the diaphragm

      Correct Answer: Increased vertical dimension of the thorax

      Explanation:

      Contraction of the diaphragm (as in inspiration) results in flattening (depression) of the diaphragm with an increase in vertical dimension of the thorax. This results in decreased intrathoracic pressure and increased intra-abdominal pressure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      48.6
      Seconds

  • Question 16 - Which of the following cervical nerves is likely to be affected if your...

    Correct

    • Which of the following cervical nerves is likely to be affected if your patient is complaining of elbow extension weakness and loss of sensation in her middle finger? She also has pain and tenderness in her cervical region, which is caused by a herniated disc, all after a whiplash-type injury in a car accident.

      Your Answer: C7

      Explanation:

      A C7 spinal nerve controls elbow extension and some finger extension. Damage to this nerve can result in a burning pain in the shoulder blade or back of the arms. The ability to extend shoulders, arms, and fingers may also be affected. Dexterity may also be compromised in the hands or fingers.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      34.5
      Seconds

  • Question 17 - Which of the following is NOT a typical feature of lithium toxicity: ...

    Correct

    • Which of the following is NOT a typical feature of lithium toxicity:

      Your Answer: Miosis

      Explanation:

      Features of toxicity include:Increasing gastrointestinal disturbances (vomiting, diarrhoea, anorexia)Visual disturbancesPolyuria and incontinenceMuscle weakness and tremorTinnitusCNS disturbances (dizziness, confusion and drowsiness increasing to lack of coordination, restlessness, stupor)Abnormal reflexes and myoclonusHypernatraemiaWith severe overdosage (serum-lithium concentration > 2 mmol/L) seizures, cardiac arrhythmias (including sinoatrial block, bradycardia and first-degree heart block), blood pressure changes, electrolyte imbalance, circulatory failure, renal failure, coma and sudden death may occur.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      28.2
      Seconds

  • Question 18 - A 30 year old man presents to ED after a road traffic accident....

    Correct

    • A 30 year old man presents to ED after a road traffic accident. Free intraperitoneal fluid is found on FAST (Focussed assessment for sonography in trauma) done in the supine position. Which of these is most likely to be affected?

      Your Answer: Hepatorenal recess

      Explanation:

      Fluid accumulates most often in the hepatorenal pouch (of Morrison) in a supine patient. The hepatorenal pouch is located behind the liver and anterior to the right kidney and is the lowest space in the peritoneal cavity in the supine position.Although the vesicouterine and rectouterine spaces are also potential spaces for fluid accumulation, fluid accumulation in them occur in the erect position.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      17.5
      Seconds

  • Question 19 - The lymph drainage of the anal canal above the pectinate line is initially...

    Incorrect

    • The lymph drainage of the anal canal above the pectinate line is initially to the:

      Your Answer: Preaortic nodes

      Correct Answer: Internal iliac nodes

      Explanation:

      Above the pectinate line, the anal canal drains to the internal iliac lymph nodes which subsequently drain to the lumbar (para-aortic) nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      40.5
      Seconds

  • Question 20 - Which of the following is NOT a typical cerebellar sign: ...

    Correct

    • Which of the following is NOT a typical cerebellar sign:

      Your Answer: Hypertonia

      Explanation:

      Hypotonia means decreased muscle tone. It can be a condition on its own, called benign congenital hypotonia, or it can be indicative of another problem where there is progressive loss of muscle tone, such as muscular dystrophy or cerebral palsy. It is usually detected during infancy. Hypotonia is characteristic of cerebellar dysfunction.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      40.1
      Seconds

  • Question 21 - The following structures all lie anteriorly to the oesophagus EXCEPT for the: ...

    Correct

    • The following structures all lie anteriorly to the oesophagus EXCEPT for the:

      Your Answer: Thoracic duct

      Explanation:

      Posterior to the oesophagus, the thoracic duct is on the right side inferiorly but crosses to the left more superiorly (at T5).

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      68.5
      Seconds

  • Question 22 - Which of the following best describes the mechanism of action of aspirin: ...

    Correct

    • Which of the following best describes the mechanism of action of aspirin:

      Your Answer: Cyclo-oxygenase (COX) inhibitor

      Explanation:

      Aspirin is a non-steroidal anti-inflammatory drug (NSAID). Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes and the resulting inhibition of prostaglandin synthesis results in analgesic, antipyretic and to a lesser extent anti-inflammatory actions.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      7.6
      Seconds

  • Question 23 - What type of visual field defect are you most likely to see in...

    Incorrect

    • What type of visual field defect are you most likely to see in a lesion of the parietal optic radiation:

      Your Answer: Contralateral homonymous superior quadrantanopia

      Correct Answer: Contralateral homonymous inferior quadrantanopia

      Explanation:

      A lesion of the parietal optic radiation will result in a contralateral homonymous inferior quadrantanopia.A lesion of the temporal optic radiation will result in a contralateral homonymous superior quadrantanopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      16
      Seconds

  • Question 24 - External haemorrhoids may cause anal pain. When explaining to your patient why it...

    Correct

    • External haemorrhoids may cause anal pain. When explaining to your patient why it does so, which of the following nerves will you point out as being affected?

      Your Answer: Pudendal nerve

      Explanation:

      The pain associated with external haemorrhoids is carried by a branch of the pudendal nerve, specifically the somatic fibres (S2-S4). It innervates the external anal sphincter and most of the skin over the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      16.2
      Seconds

  • Question 25 - Which of the following is NOT a contraindication to treatment with aspirin at...

    Correct

    • Which of the following is NOT a contraindication to treatment with aspirin at analgesic doses:

      Your Answer: Myasthenia gravis

      Explanation:

      Aspirin (at analgesic doses) is contraindicated in:People with a history of true hypersensitivity to aspirin or salicylates (symptoms of hypersensitivity to aspirin or salicylates include bronchospasm, urticaria, angioedema, and vasomotor rhinitis)People with active or previous peptic ulcerationPeople with haemophilia or another bleeding disorderChildren younger than 16 years of age (risk of Reye’s syndrome)People with severe cardiac failurePeople with severe hepatic impairmentPeople with severe renal impairmentN.B. Owing to an association with Reye’s syndrome, aspirin-containing preparations should not be given to children under 16 years, unless specifically indicated, e.g. for Kawasaki disease.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      2.8
      Seconds

  • Question 26 - A 40-year-old woman presents with retrosternal central chest pain that she has been...

    Correct

    • A 40-year-old woman presents with retrosternal central chest pain that she has been complaining about for the past two days. Upon deep inspiration and while lying flat, the pain worsens but relieved by sitting forwards. The pain radiates to both of her shoulders. The result of her ECG shows widespread concave ST-elevation and PR depression. A diagnosis of pericarditis is suspected. Which of the following nerves is responsible for the pattern of her pain?

      Your Answer: Phrenic nerve

      Explanation:

      Pericarditis is inflammation of the pericardial sac and is the most common pathologic process involving the pericardium. Frequently, pericardial inflammation can be accompanied by increased fluid accumulation within the pericardial sac forming a pericardial effusion, which may be serous, hemorrhagic or purulent depending on aetiology.The classic presentation is with chest pain that is central, severe, pleuritic (worse on deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      49.1
      Seconds

  • Question 27 - A patient complains of headache and visual loss. CT scan demonstrates a lesion...

    Correct

    • A patient complains of headache and visual loss. CT scan demonstrates a lesion of the temporal lobe. What type of visual field defect would you most expect to see in this patient:

      Your Answer: Contralateral homonymous superior quadrantanopia

      Explanation:

      Axons from the lateral geniculate nucleus (LGN) carry visual information, via the upper and lower optic radiations, to the visual cortex in the occipital lobe:The upper optic radiation carries fibres from the superior retinal quadrants (corresponding to the inferior visual field quadrants) and travels through the parietal lobe to reach the visual cortex. The lower optic radiation carries fibres from the inferior retinal quadrants (corresponding to the superior visual field quadrants) and travels through the temporal lobe to reach the visual cortex of the occipital lobe.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      25.7
      Seconds

  • Question 28 - Regarding paracetamol, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: It has anti-pyretic action.

      Explanation:

      Paracetamol is a non-opioid analgesic, similar in efficacy to aspirin, with antipyretic properties but no anti-inflammatory properties. It is well absorbed orally and does not cause gastric irritation. Paracetamol is a suitable first-line choice for most people with mild-to-moderate pain, and for combination therapy.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      49.1
      Seconds

  • Question 29 - Carbamazepine is indicated for all of the following EXCEPT for: ...

    Correct

    • Carbamazepine is indicated for all of the following EXCEPT for:

      Your Answer: Myoclonic seizures

      Explanation:

      Carbamazepine is a drug of choice for simple and complex focal seizures and is a first-line treatment option for generalised tonic-clonic seizures. It is also used in trigeminal neuralgia and diabetic neuropathy. Carbamazepine may exacerbate tonic, atonic, myoclonic and absence seizures and is therefore not recommended if these seizures are present.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      5.7
      Seconds

  • Question 30 - In the emergency room, a 28-year-old woman complains of wobbly and slurred speech,...

    Correct

    • In the emergency room, a 28-year-old woman complains of wobbly and slurred speech, is unable to do the heel-shin test, and has nystagmus. The following signs are most likely related to damage to which of the following areas:

      Your Answer: Cerebellum

      Explanation:

      Cerebellar injury causes delayed and disorganized motions. When walking, people with cerebellar abnormalities sway and stagger. Damage to the cerebellum can cause asynergia, the inability to judge distance and when to stop, dysmetria, the inability to perform rapid alternating movements or adiadochokinesia, movement tremors, staggering, wide-based walking or ataxic gait, a proclivity to fall, weak muscles or hypotonia, slurred speech or ataxic dysarthria, and abnormal eye movements or nystagmus.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      14
      Seconds

  • Question 31 - A tumour is discovered behind the pectinate line during an examination of a...

    Incorrect

    • A tumour is discovered behind the pectinate line during an examination of a 72-year-old patient with rectal bleeding. Which of the following is the lymphatic drainage of the pectinate line?

      Your Answer: Internal iliac nodes

      Correct Answer: Superficial inguinal nodes

      Explanation:

      The pectinate line is known as the watershed line because it divides the anal canal into two sections. Below the pectinate line, lymphatic drainage drains to the superficial inguinal lymph nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      5.3
      Seconds

  • Question 32 - Which of the following statements concerning the facial nerve is INCORRECT? ...

    Correct

    • Which of the following statements concerning the facial nerve is INCORRECT?

      Your Answer: Forehead sparing in facial nerve palsy is indicative of a lower motor neuron lesion.

      Explanation:

      In facial nerve palsy, LMN damage will involve the forehead and there will be an inability to close the eyes due to paralysis of the orbicularis oculi or raise the eyebrows due to paralysis of the occipitofrontalis muscle.UMN damage causes sparing of the forehead as the occipitofrontalis and orbicularis oculi muscles have bilateral cortical representation.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      38.9
      Seconds

  • Question 33 - A 70-year old male is taken to the Emergency Room after suffering a...

    Correct

    • A 70-year old male is taken to the Emergency Room after suffering a traumatic fall while showering. Upon physical examination, the attending physician noted a hyperextended neck, 1/5 muscle strength in both upper extremities, 4/5 muscle strength in both lower extremities, and variable loss in sensation. The patient is placed in the wards for monitoring. For the next 24 hours, anuria is noted.Which of the following spinal cord injuries is the most likely diagnosis?

      Your Answer: Central cord syndrome

      Explanation:

      Central cord syndrome is the most common type of incomplete cord injury and almost always occurs due to a traumatic injury. It results in motor deficits that are worse in the upper extremities as compared to the lower extremities. It may also cause bladder dysfunction (retention) and variable sensory deficits below the level of injury.The majority of these patients will be older and present with symptoms after a fall with hyperextension of their neck. On examination, patients will have more significant strength impairments in the upper extremities (especially the hands) compared to the lower extremities. Patients often complain of sensory deficits below the level of injury, but this is variable. Pain and temperature sensations are typically affected, but the sensation of light touch can also be impaired. The most common sensory deficits are in a cape-like distribution across their upper back and down their posterior upper extremities. They will often have neck pain at the site of spinal cord impingement.Bladder dysfunction (most commonly urinary retention) and priapism can also be signs of upper motor neuron dysfunction. The sacral sensation is usually preserved, but the clinician should assess the rectal tone to evaluate the severity of the compression.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      66.5
      Seconds

  • Question 34 - What is the main mechanism of action of cyclizine: ...

    Correct

    • What is the main mechanism of action of cyclizine:

      Your Answer: Histamine-H1 antagonist

      Explanation:

      Antihistamines e.g. cyclizine, are effective against nausea and vomiting caused by many different conditions, including motion sickness and vertigo. These agents act by inhibiting histamine pathways, and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. There is no evidence that any one antihistamine is superior to another but their duration of action and incidence of adverse effects differ. Adverse effects include drowsiness and antimuscarinic effects such as blurred vision, dry mouth, urinary retention, constipation and confusion.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      8
      Seconds

  • Question 35 - In inserting a nasogastric tube, which area is least likely to be a...

    Incorrect

    • In inserting a nasogastric tube, which area is least likely to be a site of resistance when the tube goes from the nose to the stomach?

      Your Answer: In the posterior mediastinum where the oesophagus is crossed by the left main bronchus

      Correct Answer: In the posterior mediastinum where the oesophagus is crossed by the pulmonary trunk

      Explanation:

      In the posterior mediastinum where the oesophagus is crossed by the pulmonary trunk offers the least resistance when nasogastric tube is inserted from the nose to the stomach.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      27.5
      Seconds

  • Question 36 - In a patient with an ongoing seizure, after what time period should treatment...

    Correct

    • In a patient with an ongoing seizure, after what time period should treatment be commenced?

      Your Answer: 5 minutes

      Explanation:

      Immediate emergency care and treatment should be given to children, young people and adults who have prolonged or repeated convulsive seizures.Prolonged seizures last 5 minutes or more. Repeated seizures refer to 3 or more seizures in an hour.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      29.7
      Seconds

  • Question 37 - Regarding the accessory nerve, which of the following statements is INCORRECT: ...

    Correct

    • Regarding the accessory nerve, which of the following statements is INCORRECT:

      Your Answer: Accessory nerve palsy results in the inability to nod the head.

      Explanation:

      Accessory nerve palsy results in inability to shrug the shoulders and to rotate the head to look at the opposite side to the lesion.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      41.7
      Seconds

  • Question 38 - Which of the following occurs at the transverse thoracic plane: ...

    Correct

    • Which of the following occurs at the transverse thoracic plane:

      Your Answer: Bifurcation of the trachea

      Explanation:

      A way to help remember the structures transected by the transverse thoracic plane is CLAPTRAP:C: cardiac plexusL: ligamentum arteriosumA: aortic arch (inner concavity)P: pulmonary trunkT: tracheal bifurcation (carina)R: right-to-left movement of the thoracic duct (posterior to the oesophagus)A: azygos vein drains into superior vena cavaP: pre-vertebral fascia and pre-tracheal fascia end

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      23.2
      Seconds

  • Question 39 - A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found...

    Incorrect

    • A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found to be malignant. Which of the following parts of the body is most likely the origin of this cancerous lymph node?

      Your Answer: Testes

      Correct Answer: Anal canal

      Explanation:

      A cancer of the anal canal below the pectinate line would spread to the superficial inguinal lymph nodes. Anal cancer often spreads through lymphatic drainage to the internal iliac lymph nodes in lesions above the pectinate line and to the superficial inguinal lymph nodes in lesions below the pectinate line.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      27.4
      Seconds

  • Question 40 - Which of the following statements is true about anterior cord syndrome? ...

    Incorrect

    • Which of the following statements is true about anterior cord syndrome?

      Your Answer: It has the best prognosis of the incomplete spinal cord injuries

      Correct Answer: There is preservation of proprioception

      Explanation:

      Anterior cord syndrome is an incomplete cord syndrome that predominantly affects the anterior 2/3 of the spinal cord, characteristically resulting in motor paralysis below the level of the lesion as well as the loss of pain and temperature at and below the level of the lesion. The patient presentation typically includes these two findings; however, there is variability depending on the portion of the spinal cord affected. Other findings include back pain, or autonomic dysfunction such as hypotension, neurogenic bowel or bladder, and sexual dysfunction. The severity of motor dysfunction can vary, typically resulting in paraplegia or quadriplegia.Proprioception, vibratory sense, two-point discrimination, and fine touch are not affected in anterior cord syndrome. These sensations are under the control of the dorsal column of the spinal cord, which is supplied by two posterior spinal arteries running in the posterior lateral sulci.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      32.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Central Nervous System (18/22) 82%
Pharmacology (12/12) 100%
Abdomen And Pelvis (1/1) 100%
Anatomy (18/28) 64%
Thorax (6/8) 75%
Cranial Nerve Lesions (3/3) 100%
Abdomen (2/6) 33%
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