-
Question 1
Correct
-
Insulin is a very important peptide hormone produced by the islets of Langerhans in the pancreas.Insulin is synthesised by which of the following cell types within the islets of Langerhans? Select ONE answer only.
Your Answer: Beta cells
Explanation:Insulin is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas. Insulin is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds. Proinsulin is synthesised as a single-chain peptide. Within storage granules, a connecting peptide (C peptide) is removed by proteases to yield insulin. Insulin release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin, but most output is driven by the rise in plasma glucose concentration that occurs after a meal. The effects of insulin are mediated by the receptor tyrosine kinase.
-
This question is part of the following fields:
- Endocrine Physiology
- Physiology
-
-
Question 2
Incorrect
-
An analytical cohort study aimed to determine a relationship between intake of dietary calcium and incidence of hip fractures among post-menopausal women. The following are the data obtained from the study:No. of post-menopausal women who took Calcium: 500No. of post-menopausal women who took Calcium and suffered a hip fracture: 10No. of post-menopausal women who took placebo: 500No. of post-menopausal women who took placebo and suffered a hip fracture: 25Compute for the absolute risk reduction of a hip fracture.
Your Answer: 0.4
Correct Answer: 0.03
Explanation:Absolute risk reduction (ARR) is computed as the difference between the absolute risk in the control group (ARC) and the absolute risk in the treatment group (ART).ARR = ARC-ARTARR = (25/500) – (10/500)ARR = 0.03
-
This question is part of the following fields:
- Evidence Based Medicine
-
-
Question 3
Incorrect
-
Which of the following is NOT a contraindication to the use of diazepam:
Your Answer: Unstable myasthenia gravis
Correct Answer: Acute alcohol withdrawal
Explanation:Benzodiazepines are used to treat symptoms in patients with acute alcohol withdrawal syndrome. Benzodiazepines are contraindicated in: Respiratory depressionMarked neuromuscular respiratory weakness, such as unstable myasthenia gravisObstructive sleep apnoea syndrome (symptoms may be aggravated)Severe hepatic impairment (the elimination half-life of diazepam may be prolonged; increased risk of coma)Phobic or obsessional states, chronic psychosis or hyperkinesis (paradoxical reactions may occur).
-
This question is part of the following fields:
- Anaesthesia
- Pharmacology
-
-
Question 4
Correct
-
A possible diagnosis of Cushing's illness is being investigated in an overweight patient with resistant hypertension. A CRH (corticotropin-releasing hormone) test is scheduled.Which of the following statements about corticotropin-releasing hormone is correct?Â
Your Answer: It is produced by cells within the paraventricular nucleus of the hypothalamus
Explanation:Corticotropin-releasing hormone (CRH) is a neurotransmitter and peptide hormone. It is generated by cells in the hypothalamic paraventricular nucleus (PVN) and released into the hypothalamo-hypophyseal portal system at the median eminence through neurosecretory terminals of these neurons. Stress causes the release of CRH.The CRH is carried to the anterior pituitary through the hypothalamo-hypophyseal portal system, where it activates corticotrophs to release adrenocorticotropic hormone (ACTH). Cortisol, glucocorticoids, mineralocorticoids, and DHEA are all produced in response to ACTH.Excessive CRH production causes the size and quantity of corticotrophs in the anterior pituitary to expand, which can lead to the creation of a corticotrope tumour that generates too much ACTH.
-
This question is part of the following fields:
- Endocrine Physiology
- Physiology
-
-
Question 5
Correct
-
Which of the following ligaments supports the head of the talus?
Your Answer: Spring ligament
Explanation:The spring-ligament complex is a significant medial arch stabilizer. The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 6
Correct
-
A new test is being developed to diagnose chlamydia. 1000 people aged 15 – 35 years attending a GUM clinic undergo the new test and the current gold standard nucleic acid amplification test (NAAT) to confirm the diagnosis. Of the 1000 people, 250 are diagnosed with chlamydia. Of the patients diagnosed with chlamydia, 240 test positive with the new diagnostic test and of the patients not diagnosed with chlamydia, 150 test positive with the new diagnostic test. What is the positive predictive value of this test:Chlamydia YesChlamydia NoTotalPositive testa= 240b = 150390Negative testc = 10d = 600610Total2507501000
Your Answer: 0.62
Explanation:Positive predictive value (PPV) is the proportion of individuals with a positive test result who actually have the disease.Positive predictive value (PPV) = a/(a+b) = 240/390 = 0.62 = 62%This means there is a 62% chance, if the test is positive, that the patient actually has chlamydia.
-
This question is part of the following fields:
- Evidence Based Medicine
- Statistics
-
-
Question 7
Correct
-
The triage nurse asks if you will prescribe a dose of codeine phosphate for a patient who is in a lot of pain. You discover that you are unable to prescribe it due to a contra-indication after evaluating the patient.The use of codeine phosphate is contraindicated in which of the following situations?
Your Answer: Age under 12 years
Explanation:Codeine phosphate is a mild opiate that can be used to treat mild to moderate pain when other pain relievers like paracetamol or ibuprofen have failed. It can also be used to treat diarrhoea and coughs that are dry or painful.The use of all opioids is contraindicated for the following reasons:Respiratory depression (acute)Patients who are comatoseHead injury (opioid analgesics impair pupillary responses, which are crucial for neurological evaluation)Intracranial pressure has risen (opioid analgesics interfere with pupillary responses vital for neurological assessment)There’s a chance you’ll get paralytic ileus.The use of codeine phosphate is contraindicated in the following situations:Because of the significant risk of respiratory side effects in children under the age of 12, it is not recommended for children under the age of 12.Patients of any age who have been identified as ultra-rapid codeine metabolizers (CYP2D6 ultra-rapid metabolizers)Because codeine can pass through breast milk to the baby and because mothers’ ability to metabolise codeine varies greatly, it is especially dangerous in breastfeeding mothers.If other painkillers, such as paracetamol or ibuprofen, fail to relieve acute moderate pain in children over the age of 12, codeine should be used. In children with obstructive sleep apnoea who received codeine after tonsillectomy or adenoidectomy, a significant risk of serious and life-threatening adverse reactions has been identified.
-
This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
-
-
Question 8
Correct
-
A 22-year-old man comes to the emergency department with a human bite injury to his hand received from a punch during a fight 3 hours earlier outside a bar. On closer inspection, you discover bite marks on his first and second knuckles. Which of the following is the best treatment option for this patient:
Your Answer: Oral co-amoxiclav for 7 days
Explanation:Even if there is no evidence of infection, prophylactic antibiotics should be administered for all human bite wounds that are less than 72 hours old. The first-line therapy is 7 days of co-amoxiclav. In penicillin-allergic people, metronidazole + doxycycline is an option. Streptococcus spp., Staphylococcus aureus, Haemophilus spp., Eikenella corrodens, Bacteroides spp., and other anaerobes are the most prevalent organisms found in human bites.
-
This question is part of the following fields:
- Infections
- Microbiology
-
-
Question 9
Incorrect
-
Regarding Clostridium perfringens, which of the following statements is CORRECT:
Your Answer: It is typically found in contaminated water supply.
Correct Answer: It can cause exotoxin-mediated food poisoning.
Explanation:Clostridium perfringens is an obligate anaerobe and has exotoxin mediated effects. It is the most common cause of gas gangrene. C. perfringens is also implicated in food poisoning, cellulitis, enteritis necrotican (life-threatening infection involving ischaemic necrosis of the jejunum), and rarely, CNS infections such as meningitis and encephalitis.
-
This question is part of the following fields:
- Microbiology
- Pathogens
-
-
Question 10
Correct
-
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).
-
This question is part of the following fields:
- Anatomy
- Upper Limb
-
-
Question 11
Incorrect
-
One of these statements about cohort studies is true:
Your Answer: They are the best way to determine the prevalence of a disease
Correct Answer: They are longitudinal in nature
Explanation:A cohort study is a longitudinal, observational study. It follows a group of patients (the cohort) forward in time and monitors the effects of the aetiological factor under study upon them.Cohort studies are usually of longer duration and are more expensive than case-control studies. They, however, provide more useful and reliable information.Cohort studies follow a cohort of patients who don’t have a disease and evaluate the absolute and relative risk of contracting the disease after exposure to the aetiological agent.Cross-sectional studies are the best way to determine the prevalence of a disease. while Cohort studies are better at determining the incidence of a disease.
-
This question is part of the following fields:
- Evidence Based Medicine
-
-
Question 12
Correct
-
A 29-year-old man is diagnosed with a severe case of asthma.In the treatment of acute asthma in adults, which of the following is NOT recommended?Â
Your Answer: Nebulised magnesium
Explanation:There is no evidence to support the use of nebulized magnesium sulphate in the treatment of adults at this time.In adults with acute asthma, the following medication dosages are recommended:By using an oxygen-driven nebuliser, you can get 5 milligrams of salbutamol.500 mcg ipratropium bromide in an oxygen-driven nebuliserOral prednisolone 40-50 mg100 mg hydrocortisone intravenous1.2-2 g magnesium sulphate IV over 20 minutesWhen inhaled treatment is ineffective, intravenous salbutamol (250 mcg IV slowly) may be explored (e.g. a patient receiving bag-mask ventilation).Following senior counsel, current ALS recommendations propose that IV aminophylline be explored in severe or life-threatening asthma. If utilized, a loading dose of 5 mg/kg should be administered over 20 minutes, then a 500-700 mcg/kg/hour infusion should be given. To avoid toxicity, serum theophylline levels should be kept below 20 mcg/ml.
-
This question is part of the following fields:
- Pharmacology
- Respiratory Pharmacology
-
-
Question 13
Correct
-
A 60-year-old female has a past medical history of diverticular disease. She now presents in the clinic with crampy abdominal pain. The nurse at the triage suggests prescribing hyoscine butyl bromide to help relieve the abdominal pain. However, after administering this treatment, the patient develops a side-effect to the medication. What side-effect of using hyoscine butyl bromide is she MOST likely to develop out of the following?
Your Answer: Dry mouth
Explanation:Hyoscine butylbromide is an antispasmodic drug that blocks muscarinic receptors and reduces intestinal motility. It is used for gastrointestinal and genitourinary smooth muscle spasms and symptomatic relief of IBS.It has the following side-effects:1. Constipation2. Dizziness3. Drowsiness4. Dry mouth5. Dyspepsia6. Flushing7. Headache8. Nausea and vomiting9. Palpitations10. Skin reactions11. Tachycardia12. Urinary disorders13. Disorders of vision
-
This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
-
-
Question 14
Correct
-
Where on the body is the radial artery pulsation best palpated?
Your Answer: At the wrist just lateral to the flexor carpi radialis tendon
Explanation:The radial artery lies lateral to the large tendon of the flexor carpi radialis muscle and anterior to the pronator quadratus at the distal end of the radius. The flexor carpi radialis muscle is used as a landmark in locating the pulse.
-
This question is part of the following fields:
- Anatomy
- Upper Limb
-
-
Question 15
Incorrect
-
In a 7-year-old child with chickenpox, which of the following would you advise the mother NOT to do?
Your Answer: Use anti-histamines to help ease the itching
Correct Answer: Give ibuprofen for the fever
Explanation:Chickenpox (varicella zoster) is a highly contagious airborne disease and has an incubation period of between 7-21 days. It often has a prodromal phase when there is a fever, aches and headaches, dry cough, and sore throat before onset of rash.Some recognized complications of chickenpox are:OrchitisHepatitisPneumoniaEncephalitisInfected spotsOtitis mediaMyocarditisGlomerulonephritisAppendicitisPancreatitisTreatment is symptomatic and includes using paracetamol to manage fever. There is a link between use of ibuprofen in patients with chicken-pox and necrotizing fasciitis so Ibuprofen should NOT be used. An emollient and antihistamine can be used to ease the itchy rash and oral hydration is encouraged.
-
This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
-
-
Question 16
Correct
-
Which of the following is the most potent stimulus of fibrinolysis:
Your Answer: Tissue plasminogen activator
Explanation:Fibrinolysis is a normal haemostatic response to vascular injury. Plasminogen, a proenzyme in blood and tissue fluid, is converted to plasmin by activators either from the vessel wall (intrinsic activation) or from the tissues (extrinsic activation). The most important route follows the release of tissue plasminogen activator (TPA) from endothelial cells.
-
This question is part of the following fields:
- Basic Cellular
- Physiology
-
-
Question 17
Correct
-
During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate was prematurely born with cyanosis and ashen grey coloured skin as a result of this. Other symptoms were hypotonia, low blood pressure, and poor feeding.From the  following antibiotics, which one is most likely to cause this side effect?Â
Your Answer: Chloramphenicol
Explanation:Grey baby syndrome is a rare but causes significant adverse effect caused by the build-up of chloramphenicol in neonates (particularly preterm babies).The following are the main characteristics of ‘grey baby syndrome’:Skin that is ashy grey in colour.Feeding problemsVomitingCyanosisHypotensionHypothermiaHypotoniaCollapse of the cardiovascular systemDistension of the abdomentrouble breathing
-
This question is part of the following fields:
- Infections
- Pharmacology
-
-
Question 18
Correct
-
The juxtacapillary receptors, or J receptors, are sensory cells that play an important role in the control of respiration.At which of the following anatomical sites are the J receptors located? Select ONE answer only.
Your Answer: The alveolar walls
Explanation:Juxtacapillary receptors (J receptors) are sensory cells that are located within the alveolar walls in juxtaposition to the pulmonary capillaries of the lung.The J receptors are innervated by the vagus nerve and are activated by physical engorgement of the pulmonary capillaries or increased pulmonary interstitial volume, for example, in the presence of pulmonary oedema, pulmonary embolus, pneumonia and barotraumas. They may also be stimulated by hyperinflation of the lung.Stimulation of the J receptors causes a reflex increase in breathing rate and is also thought to be involved in the sensation of dyspnoea. The reflex response that is produced is apnoea, followed by rapid breathing, bradycardia, and hypotension.
-
This question is part of the following fields:
- Physiology
- Respiratory Physiology
-
-
Question 19
Correct
-
Which of the following muscles are primarily involved in passive inspiration:
Your Answer: Diaphragm and external intercostal muscles
Explanation:Passive inspiration is produced by contraction of the diaphragm (depressing the diaphragm) and the external intercostal muscles (elevating the ribs). In inspiration, elevation of the sternal ends of the ribs (‘pump handle’ movement), elevation of the lateral shafts of the ribs (‘bucket handle’ movement) and depression of the diaphragm result in expansion of the thorax in an anteroposterior, transverse and vertical direction respectively. This results in an increased intrathoracic volume and decreased intrathoracic pressure and thus air is drawn into the lungs.
-
This question is part of the following fields:
- Anatomy
- Thorax
-
-
Question 20
Incorrect
-
A somatostatinoma is diagnosed in a 74-year-old patient who has recently developed diabetes mellitus, recurrent episodes of gallstones, and Steatorrhoea. She also has a tumour in the head of her pancreas.Which of the following is the most likely effect of this tumour?Â
Your Answer: Increase secretin levels
Correct Answer: Inhibit gastric acid secretion
Explanation:Somatostatin-producing cells present in the pyloric antrum, duodenum, and pancreatic islets are known as D-cells or delta-cells. Somatostatin inhibits gastric acid secretion by acting directly on acid-producing parietal cells in the stomach via a G-protein coupled receptor.Somatostatin affects hormones in the following ways:Inhibits the anterior pituitary’s secretion of growth hormone.Inhibits the anterior pituitary’s secretion of thyroid-stimulating hormone.The secretion of various gastrointestinal hormones is inhibited (including gastrin, CCK, secretin, motilin, VIP and GIP) Reduces the rate at which the stomach empties.Inhibits the release of insulin and glucagon from the pancreas.The pancreas’ exocrine secretory activity is inhibited.Somatostatin can also slow the digestive process by suppressing the production of hormones such gastrin, secretin, and histamine, which reduces gastric acid secretion.A somatostatinoma is a cancerous tumour of the endocrine pancreas’ D-cells, which make somatostatin. Somatostatin inhibits pancreatic and gastrointestinal hormones when levels are high. The following clinical characteristics are related with somatostatinomas:Insulin secretion blockage causes diabetes mellitus.Gallstones by inhibition of CCK and secretin Steatorrhoea via inhibition of CCK and secretinHypochlorhydria is caused by the suppression of gastrin, a hormone that increases gastric acid output regularly.
-
This question is part of the following fields:
- Gastrointestinal Physiology
- Physiology
-
-
Question 21
Correct
-
In the extrinsic pathway of the coagulation cascade, the tenase complex is:
Your Answer: Factor VIIa-tissue factor complex
Explanation:The extrinsic pathway for initiating the formation of prothrombin activator begins with a traumatized vascular wall or traumatized extravascular tissues that come in contact with the blood. Exposed and activated by vascular injury, with plasma factor VII. The extrinsic tenase complex, factor VIIa-tissue factor complex, activates factor X to factor Xa.
-
This question is part of the following fields:
- Basic Cellular
- Physiology
-
-
Question 22
Incorrect
-
You review a 50-year-old man that is requesting the seasonal influenza vaccination.Which of the following single clinical risk groups is NOT eligible to receive the seasonal influenza vaccination? Select ONE answer only.
Your Answer: All pregnant women
Correct Answer: Patients over the age of 50
Explanation:Patients with hypertension are only eligible for the seasonal influenza vaccination if they have co-existent cardiac complications.The UK national policy is that the seasonal influenza vaccine should be offered to the following groups:All those aged 65 years and olderChildren aged 2 to 15 yearsResidents of nursing and residential homes for the elderly (and other long-stay facilities)Carers of persons whose welfare may be at risk if the carer falls illAll those aged 6 months or older in a clinical risk groupThe following table outlines the clinical risk groups that are considered eligible for the vaccine:CategoryExamples of eligible groupsRespiratory diseaseCOPDInterstitial lung diseaseCystic fibrosisAsthma (requiring oral or inhaled steroids)Heart diseaseCongenital heart diseaseChronic heart failureCoronary heart disease (requiring medication and/or follow-up)Hypertension with cardiac complicationsKidney diseaseChronic kidney diseaseNephrotic syndromeRenal transplant patientsLiver diseaseLiver cirrhosisChronic hepatitisBiliary atresiaNeurological diseaseCerebrovascular accidentTransient ischaemic attackEndocrine diseaseType 1 and 2 diabetesImmunosuppressionPatients undergoing chemotherapyPatients taking immunosuppressive drug therapy (including systemic steroids)Asplenia or splenic dysfunctionHIV infectionPregnancyAll pregnant women
-
This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
-
-
Question 23
Correct
-
Regarding amoxicillin, which of the following statements is INCORRECT:
Your Answer: It is used first line for bacterial tonsillitis.
Explanation:Amoxicillin is a derivative of ampicillin and has a similar antibacterial spectrum. It is better absorbed than ampicillin when given orally, producing higher plasma and tissue concentrations; unlike ampicillin, absorption is not affected by the presence of food in the stomach. The adverse effects of amoxicillin are mainly gastrointestinal and mild and include nausea, vomiting and diarrhoea. Amoxicillin is used first line for low to moderate severity community acquired pneumonia, exacerbations of chronic bronchitis, for acute otitis media, for acute sinusitis, for oral infections/dental abscess, for Listeria meningitis (in combination with another antibiotic), for infective endocarditis (in combination with another antibiotic) and for H. Pylori eradication (in combination with metronidazole/clarithromycin and a PPI). Penicillin V is used first line for bacterial tonsillitis; amoxicillin should be avoided in blind treatment of a sore throat as there is a high risk of a rash if glandular fever is present.
-
This question is part of the following fields:
- Infections
- Pharmacology
-
-
Question 24
Correct
-
Regarding the phases of gastric secretion, which of the following statements is INCORRECT:
Your Answer: A high pH in the stomach inhibits gastrin secretion.
Explanation:A low pH in the stomach inhibits gastrin secretion, therefore when the stomach is empty or when acid has been secreted for some time after food has entered it, there is inhibition of acid secretion. However, when food first enters the stomach, the pH rises, and this leads to release of the inhibition and causes a maximum secretion of gastrin. Thus gastric acid secretion is self-regulating.
-
This question is part of the following fields:
- Gastrointestinal
- Physiology
-
-
Question 25
Incorrect
-
A 65-year-old man complains of severe vertigo, nausea, and tinnitus. Upon presenting himself to the emergency room, it was observed that he is exhibiting ataxia, right-sided loss of pain and temperature sense on the face, and left-sided sensory loss to the body. An MRI and CT scan was ordered and the results showed that he is suffering from a right-sided stroke. Branches of which of the following arteries are most likely implicated in the case?
Your Answer: Posterior cerebral artery
Correct Answer: Basilar artery
Explanation:The lateral pontine syndrome occurs due to occlusion of perforating branches of the basilar and anterior inferior cerebellar (AICA) arteries. It is also known as Marie-Foix syndrome or Marie-Foix-Alajouanine syndrome. It is considered one of the brainstem stroke syndromes of the lateral aspect of the pons.It is characterized by ipsilateral limb ataxia, loss of pain and temperature sensation of the face, facial weakness, hearing loss, vertigo and nystagmus, hemiplegia/hemiparesis, and loss of pain and temperature sensation.
-
This question is part of the following fields:
- Anatomy
- Central Nervous System
-
-
Question 26
Correct
-
Regarding inhaled corticosteroids, which of the following statements is INCORRECT:
Your Answer: Lower doses of inhaled corticosteroids may be required in smokers.
Explanation:Current and previous smoking reduces the effectiveness of inhaled corticosteroids and higher doses may be necessary.
-
This question is part of the following fields:
- Pharmacology
- Respiratory
-
-
Question 27
Correct
-
You plan to use plain 1% lidocaine for a ring block on a finger that needs suturing.Which SINGLE statement regarding the use of 1% lidocaine, in this case, is true?
Your Answer: Lidocaine works by blocking fast voltage-gated sodium channels
Explanation:Lidocaine is a tertiary amine that is primarily used as a local anaesthetic but can also be used intravenously in the treatment of ventricular dysrhythmias.Lidocaine works as a local anaesthetic by diffusing in its uncharged base form through neural sheaths and the axonal membrane to the internal surface of the cell membrane sodium channels. Here it alters signal conduction by blocking the fast voltage-gated sodium channels. With sufficient blockage, the membrane of the postsynaptic neuron will not depolarise and will be unable to transmit an action potential, thereby preventing the transmission of pain signals.Each 1 ml of plain 1% lidocaine solution contains 10 mg of lidocaine hydrochloride. The maximum safe dose of plain lidocaine is 3 mg/kg. When administered with adrenaline 1:200,000, the maximum safe dose is 7 mg/kg. Because of the risk of vasoconstriction and tissue necrosis, lidocaine should not be used in combination with adrenaline in extremities such as fingers, toes, and the nose.The half-life of lidocaine is 1.5-2 hours. Its onset of action is rapid within a few minutes, and it has a duration of action of 30-60 minutes when used alone. Its duration of action is prolonged by co-administration with adrenaline (about 90 minutes).Lidocaine tends to cause vasodilatation when used locally. This is believed to be due mainly to the inhibition of action potentials via sodium channel blocking in vasoconstrictor sympathetic nerves.
-
This question is part of the following fields:
- Anaesthesia
- Pharmacology
-
-
Question 28
Correct
-
Regarding co-amoxiclav, which of the following statements is INCORRECT:
Your Answer: Clavulanic acid acts to inhibit cross-linking of bacterial peptidoglycan polymers.
Explanation:Co-amoxiclav consists of amoxicillin with the beta-lactamase inhibitor clavulanic acid. Clavulanic acid itself has no significant antibacterial activity but, by inactivating beta-lactamases, it makes the combination active against beta-lactamase-producing bacteria that are resistant to amoxicillin.The most common adverse effects of co-amoxiclav include nausea, vomiting, skin rash and diarrhoea. Pseudomembranous colitis should be considered if a person develops severe diarrhoea during or after treatment with co-amoxiclav. Cholestatic jaundice can occur either during or shortly after the use of co-amoxiclav. An epidemiological study has shown that the risk of acute liver toxicity was about 6 times greater with co-amoxiclav than with amoxicillin. Cholestatic jaundice is more common in patients above the age of 65 years and in men; these reactions have only rarely been reported in children. Jaundice is usually self-limiting and very rarely fatal.
-
This question is part of the following fields:
- Infections
- Pharmacology
-
-
Question 29
Incorrect
-
You are reviewing a patient in the Emergency Department brought in by the ambulance team from a burning building. After examination, you decide to intubate the patient due to laryngeal oedema. The induction agent you are planning to use is propofol. Which one of the following statements about this medicine is TRUE?
Your Answer: 75% of patients experience pain on injection
Correct Answer: It decreases cardiac output by approximately 20%
Explanation:Propofol is a short-acting anaesthetic that is thought to work by potentiating GABA and glycine. It induces anterograde amnesia and anaesthetic effects and is used to induce anaesthesia, outpatient surgeries and preoperative sedation. The dose for induction of anaesthesia is 1.5-2.5mg/kg. The dose for maintenance of anaesthesia is 4-12 mg/kg/hour. Following intravenous injection, propofol acts within 30 seconds and its duration of action is 5-10 minutes.Propofol produces a 15-25% decrease in blood pressure and systemic vascular resistance without a compensatory increase in heart rate. It is negatively inotropic and decreases cardiac output by approximately 20%.The main side effects of propofol are:Pain on injection (in up to 30%)HypotensionTransient apnoeaHyperventilationCoughing and hiccoughHeadacheThrombosis and phlebitis
-
This question is part of the following fields:
- Anaesthesia
- Pharmacology
-
-
Question 30
Correct
-
Regarding the lumbar plexus, which of the following is a direct muscular branch?
Your Answer: Nerve to quadratus lumborum
Explanation:The lumbar plexus gives rise to several branches which supply various muscles and regions of the posterior abdominal wall and lower limb. These branches include the Iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral and obturator nerves.In addition, the lumbar plexus gives off muscular branches from its roots, a branch to the lumbosacral trunk and occasionally an accessory obturator nerve.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
SESSION STATS - PERFORMANCE PER SPECIALTY
