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Question 1
Incorrect
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The average BP reading on ambulatory blood pressure monitoring for a 59-year-old Caucasian man is 152/96 mmHg (ABPM).The first-line drug treatment for this patient would be which of the following? Please only choose ONE answer.
Your Answer: Ramipril
Correct Answer: Amlodipine
Explanation:An ambulatory blood pressure reading of >150/95 is classified as stage 2 hypertension, according to the NICE care pathway for hypertension, and the patient should be treated with an antihypertensive drug.A calcium-channel blocker, such as amlodipine, would be the most appropriate medication for a 59-year-old Caucasian man.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 2
Incorrect
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A 34-year-old woman was diagnosed with multiple sclerosis two years ago. Her symptoms have been steadily deteriorating, with no intervals of remission in sight.Which of the following aspects of nerve conduction is disrupted by multiple sclerosis?
Your Answer: Potassium channel function
Correct Answer: Saltatory conduction
Explanation:Local currents propagate action potentials down the axons of neurons. This local current flow following depolarisation results in the depolarisation of the neighbouring axonal membrane, and when this region approaches the threshold, more action potentials are generated and so forth. Due to the refractory period, portions of the membrane that have recently depolarized will not depolarize again, resulting in the action potential only being able to go in one direction.The square root of axonal diameter determines the velocity of the action potential; the axons with the biggest diameter have the quickest conduction velocities. When a neuron is myelinated, the speed of the action potential rises as well.The myelin sheath is an insulating coating that surrounds certain neural axons. By increasing membrane resistance and decreasing membrane capacitance, the myelin sheath improves conduction. This enables faster electrical signal transmission via a neuron, making them more energy-efficient than non-myelinated neuronal axons.Electrical impulses are quickly transmitted from one node to the next, causing depolarization of the membrane above the threshold and triggering another action potential, which is then transmitted to the next node. An action potential is rapidly conducted down a neuron in this manner. Saltatory conduction is the term for this.Multiple sclerosis is an example of a clinical disorder in which the myelin sheath is affected. It is an immune-mediated disorder in which certain nerve cells in the brain and spinal cord become demyelinated. The ability of some areas of the nervous system to properly transmit action potentials is disrupted by demyelination, resulting in a variety of neurological symptoms and indications.
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This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 3
Correct
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Which of the following muscles is NOT involved in depression of the mandible:
Your Answer: Masseter
Explanation:Depression of the mandible is generated by the digastric, geniohyoid, mylohyoid and lateral pterygoid muscles on both side, assisted by gravity. The lateral pterygoid muscles are also involved as this movement also involves protraction of the mandible. The masseter muscle is a powerful elevator of the mandible.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 4
Incorrect
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When a child has mumps, how long should he or she be off from school?
Your Answer: No exclusion period
Correct Answer: 5 days from onset of swelling
Explanation:To avoid the spread of infection, infected patients should be isolated. Patients should avoid going to school, childcare, or job for five days after the swelling has occurred.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 5
Incorrect
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You're evaluating a male patient who's having a lung function test done. In calculating the patient’s functional residual capacity, what parameters should you add to derive the functional residual capacity volume?
Your Answer: Inspiratory reserve volume + tidal volume
Correct Answer: Expiratory reserve volume + residual volume
Explanation:The volume of air that remains in the lungs after a single breath is known as functional residual capacity (FRC). It is calculated by combining the expiratory reserve volume and residual volume.
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This question is part of the following fields:
- Physiology
- Respiratory Physiology
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Question 6
Incorrect
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All of the following statements are correct regarding the management of acute asthma in adults except:
Your Answer: Continuous salbutamol nebulisation should be considered in patients with severe acute asthma that is poorly responsive to initial bolus dose of salbutamol.
Correct Answer: Intravenous aminophylline has been shown to result in significant additional bronchodilation compared to standard care.
Explanation:There usually isn’t any additional bronchodilation with intravenous (IV) aminophylline compared to standard care with inhaled bronchodilators and steroids. IV aminophylline may cause side effects such as arrhythmias and vomiting. However, some additional benefit may be gained in patients with near-fatal asthma or life-threatening asthma with a poor response to initial therapy (5 mg/kg loading dose over 20 minutes unless on maintenance oral therapy, then continuous infusion of 0.5 – 0.7 mg/kg/hr).
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This question is part of the following fields:
- Pharmacology
- Respiratory
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Question 7
Incorrect
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In adults in the United Kingdom, which of the following pathogens is the most likely cause of viral infectious gastroenteritis:
Your Answer: Rotavirus
Correct Answer: Norovirus
Explanation:Norovirus is the most common viral cause of epidemic gastroenteritis worldwide; it is also a common cause of endemic diarrhoea in community settings. In the United Kingdom, norovirus has become the most common cause of gastroenteritis in adults and children since the introduction of rotavirus vaccination.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 8
Incorrect
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An 82 year old man taking warfarin as a maintenance medication comes in to your clinic because of an infection. Which antibiotic is the safest choice for this patient?
Your Answer: Doxycycline
Correct Answer: Cefalexin
Explanation:Alterations in the international normalized ratio (INR) brought about by the concurrent use of antibiotics and warfarin may result in either excessive clotting or excessive bleeding if they are deemed to have a high risk for interaction. As such, there should be careful consideration of the class of antibiotic to be used. Antibiotics from the following drug classes should generally be avoided as they have a high risk for interaction with warfarin, possible enhancing the anticoagulant effects of warfarin resulting in bleeding: Fluoroquinolones (e.g. ciprofloxacin, levofloxacin), Macrolides (e.g. clarithromycin, erythromycin, azithromycin), Nitroimidazoles (e.g. metronidazole), Sulphonamides (e.g. co-trimoxazole, a combination of trimethoprim and sulfamethoxazole), Trimethoprim, Tetracyclines (e.g. doxycycline). Low risk antibiotics that have low risk for interaction with warfarin includes cephalexin, from the cephalosporin class, and clindamycin which is a lincomycin.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 9
Correct
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A 71-year-old man treated with antibiotics for a chest infection returns with a profuse, offensive smelling diarrhoea. A diagnosis of Clostridium difficile diarrhoea is made after investigations.The action most effective at minimizing spread to other patients is?
Your Answer: Hand washing
Explanation:Clostridium difficile, a Gram-positive, anaerobic, spore forming bacteria is present in the gut of approximately 3% of healthy adults (2012 UK HPA estimates). Following use of broad spectrum antibiotics, which alter normal gut flora, Clostridium difficile associated diarrhoea (CDAD) occurs.Alcohol hand gel is not effective against Clostridium Difficile spores. Hand washing with soap and water is very essential for healthcare workers who come in contact with it.Wearing an apron and gloves, and isolation to a side room are important contact precautions. They are, however, ineffective if hand washing is neglected.Although oral vancomycin is the first-line treatment for C. difficile associated diarrhoea, it will not limit patient to patient spread.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 10
Incorrect
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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: Each 1 ml of solution contains 1 mg of lidocaine hydrochloride
Correct 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.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 11
Incorrect
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Which of the following statements is true regarding the extensor pollicis longus?
Your Answer: It extends the thumb at the carpometacarpal joint
Correct Answer: It is innervated by the posterior interosseous nerve
Explanation:Extensor pollicis longus is part of the deep extensors of the forearm together with extensor pollicis brevis, abductor pollicis longus, extensor indicis and supinator muscles. It is located on the posterior aspect of forearm, extending from the middle third of the ulna, and adjacent interosseous membrane, to the distal phalanx of the thumb.Extensor digitorum is innervated by posterior interosseous nerve which is a continuation of a deep branch of radial nerve (root value C7 and C8).Extensor pollicis brevis receives its blood supply from the posterior interosseous artery and perforating branches of the anterior interosseous artery.The main action of extensor pollicis longus is extension of the thumb at the metacarpophalangeal and interphalangeal joints. Extension at the metacarpophalangeal joint occurs in synergy with extensor pollicis brevis muscle. When the thumb reaches the full extension or abduction, extensor pollicis longus can also assist in adduction of the thumb.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 12
Incorrect
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An analytical cohort study is done to compare the relationship between omega 3 intake and occurrence of myocardial infarction (MI) among males aged over 65 years. The following are the data from the study:No. of subjects taking placebo: 100 menNo. of subjects taking placebo who suffered an MI: 15 menNo. of subjects taking omega 3: 100 menNo. of subjects taking omega 3 who suffered an MI: 5 menCompute for the relative risk of the study.
Your Answer: 3
Correct Answer: 0.33
Explanation:Relative risk (RR) is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.RR can be computed as the absolute risk of events in the treatment group (ART), divided by the absolute risk of events in the control group (ARC).RR = ART/ARCRR = (5/100) / (15/100)RR = 0.33
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This question is part of the following fields:
- Evidence Based Medicine
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Question 13
Incorrect
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A type II error occurs when:
Your Answer: The alternative hypothesis is accepted when it is false.
Correct Answer: The null hypothesis is accepted when it is false.
Explanation:A type II error occurs when the null hypothesis is wrongly accepted when it is actually false and we conclude that there is no evidence of a difference in effect when one really exists (a false negative result).
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 14
Correct
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A 26-year old female comes to the Emergency Room with complaints of bloody stools. She reports that prior to the passage of bloody stools, she experienced a sharp pain during defecation. Medical history reveals that she has been experiencing constipation for the past 2 weeks. After completing her medical history and physical examination, the attending physician gives an initial diagnosis of an anal fissure.Which of the following nerves transmit painful sensation from the anus, resulting in the pain associated with anal fissure?
Your Answer: Inferior rectal nerve
Explanation:A fissure in ano is a tear in the anoderm distal to the dentate line. The pathophysiology of anal fissure is thought to be related to trauma from either the passage of hard stool or prolonged diarrhoea. A tear in the anoderm causes spasm of the internal anal sphincter, which results in pain, increased tearing, and decreased blood supply to the anoderm. The site of the anal fissure in the sensitive lower half of the anal canal, which is innervated by the inferior rectal nerve, results in reflex spasm of the external anal sphincter, aggravating the condition. Because of the intense pain, anal fissures may have to be examined under local anaesthesia.The inferior rectal nerve is a branch of the pudendal nerve. This nerve runs medially across the ischiorectal fossa and supplies the external anal sphincter, the mucous membrane of the lower half of the anal canal, and the perianal skin.
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This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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Question 15
Incorrect
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Regarding thalassaemia, which of the following statements is CORRECT:
Your Answer: Beta-thalassaemia is more common in the Far East.
Correct Answer: Screening for thalassaemia in pregnancy is offered to all pregnant women.
Explanation:Beta thalassemia is caused by mutations in one or both of the beta globin genes. Alpha thalassemia is caused by a deletion or mutation (less commonly) in one or more of the four alpha globin gene copies. β-thalassaemia is more common in the Mediterranean region while α-thalassaemia is more common in the Far East.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 16
Incorrect
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The causative organism for an infection in a patient you are reviewing is a facultative anaerobe.Which of these is a facultative anaerobic organism?
Your Answer: Clostridium perfringens
Correct Answer: Staphylococcus aureus
Explanation:Facultative anaerobic bacteria make energy in the form of ATP by aerobic respiration in an oxygen rich environment and can switch to fermentation in an oxygen poor environment.Examples of facultative anaerobes are:Staphylococcus spp.Listeria spp.Streptococcus spp.Escherichia coliMycobacterium tuberculosis, and Pseudomonas aeruginosa are obligate aerobe. They require oxygen to growCampylobacter jejuni and Clostridium spp are obligate anaerobes.They live and grow in the absence of oxygen.
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This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 17
Incorrect
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Regarding CSF (cerebrospinal fluid) production, approximately how much is produced per day?
Your Answer: 50 ml
Correct Answer: 500 ml
Explanation:CSF fills the ventricular system, a series of interconnected spaces within the brain, and the subarachnoid space directly surrounding the brain. The intraventricular CSF reflects the composition of the brain’s extracellular space via free exchange across the ependyma, and the brain “floats” in the subarachnoid CSF to minimize the effect of external mechanical forces. The volume of CSF within the cerebral ventricles is approximately 30 mL, and that in the subarachnoid space is about 125 mL. Because about 0.35 mL of CSF is produced each minute, CSF is turned over more than three times daily. Approximately 500 mL of CSF is produced per day, at a rate of about 25 mL per hour.CSF is a filtrate of capillary blood formed largely by the choroid plexuses, which comprise pia mater, invaginating capillaries, and ependymal cells specialized for transport. The choroid plexuses are located in the lateral, third, and fourth ventricles. The lateral ventricles are situated within the two cerebral hemispheres. They each connect with the third ventricle through one of the interventricular foramina (of Monro). The third ventricle lies in the midline between the diencephalon on the two sides. The cerebral aqueduct (of Sylvius) traverses the midbrain and connects the third ventricle with the fourth ventricle. The fourth ventricle is a space defined by the pons and medulla below and the cerebellum above. The central canal of the spinal cord continues caudally from the fourth ventricle, although in adult humans the canal is not fully patent and continues to close with age.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 18
Correct
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Which of the following is the most abundant immunoglobulin in plasma:
Your Answer: IgG
Explanation:IgA is the major Ig in secretions, particularly from the gastrointestinal tract (but also in saliva, tears, sweat and breast milk).IgE is important for mast cell degranulation in allergic and antiparasitic response. In the allergic response, the plasma cell produces IgE-antibodies, which, like antibodies of other immunoglobulin isotypes, are capable of binding a specific allergen via its Fab portion.IgG is the most abundant in plasma (comprising 80% of normal serum immunoglobulin) and the main circulatory Ig for the secondary immune response.
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 19
Incorrect
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Excessive gastric acid output is detected in a patient with a history of recurrent stomach ulcers. It's possible that the patient has Zollinger-Ellison syndrome.Which of the following statements about stomach acid is correct?
Your Answer: It is secreted by chief cells
Correct Answer: The proton pump located in the canalicular membrane is vital to its secretion
Explanation:The stomach produces gastric acid, which is a digesting fluid. The stomach secretes about 2-3 litres every day. It is involved in tissue breakdown, the conversion of pepsinogen to active pepsin, and the creation of soluble salts with calcium and iron, and has a pH range of 1.5-3.5. It also serves as an immune system by destroying microbes.The following substances are found in gastric acid:WaterAcid hydrochloridePepsinogenmucous Intrinsic factorThe parietal cells in the proximal 2/3 (body) of the stomach release gastric acid. The concentration of hydrogen ions in parietal cell secretions is 1-2 million times that of blood. Chloride is released against both a concentration and an electric gradient, and active transport is required for the parietal cell to produce acid.The following is how stomach acid is secreted:1. Gastric acid secretion is dependent on the H+/K+ ATPase (proton pump) situated in the canalicular membrane. The breakdown of water produces hydrogen ions within the parietal cell. The hydroxyl ions produced in this reaction mix quickly with carbon dioxide to generate bicarbonate ions. Carbonic anhydrase is the enzyme that catalyses this process.2. In return for chloride, bicarbonate is carried out of the basolateral membrane. The ‘alkaline tide’ occurs when bicarbonate is released into the bloodstream, resulting in a modest rise in blood pH. The parietal cell’s intracellular pH is maintained by this procedure. Conductance channels carry chloride and potassium ions into the lumen of canaliculi.3. Through the action of the proton pump, hydrogen ions are pushed out of the cell and into the lumen in exchange for potassium; potassium is thus efficiently recycled.4. The canaliculi accumulate osmotically active hydrogen ions, which creates an osmotic gradient across the membrane, allowing water to diffuse outward.
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This question is part of the following fields:
- Gastrointestinal Physiology
- Physiology
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Question 20
Incorrect
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A 52-year-old female visits the Emergency Department complaining of an acute worsening of her asthma symptoms. A detailed history reveals that she took one of her brother's heart pills without a prescription as she was experiencing palpitations and thought it would cure her. Her shortness of breath was suddenly exacerbated after ingesting this medicine. Which one of the following medications has this woman most likely consumed?
Your Answer: Bisoprolol
Correct Answer: Propranolol
Explanation:Propranolol, like other non-selective beta-blockers, is contraindicated in patients with asthma. These drugs can cause acute bronchospasm, therefore worsening symptoms, especially in high doses. However, there has been some recent evidence that long-term use of selective beta-blockers in mild or moderate asthma patients can be safe.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 21
Incorrect
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The following are all examples of type III hypersensitivity EXCEPT for:
Your Answer: Extrinsic allergic alveolitis
Correct Answer: Goodpasture's syndrome
Explanation:Examples of type III reactions include:Extrinsic allergic alveolitisSystemic lupus erythematosus (SLE)Post-streptococcal glomerulonephritisReactive arthritisRheumatoid arthritis
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 22
Correct
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An X-ray of a 24-year-old female hockey player who arrives at the hospital with a left foot injury reveals an avulsion fracture of the fifth metatarsal tuberosity. Which of the following muscles is most likely responsible for the movement of the fractured fragment?
Your Answer: Fibularis brevis
Explanation:An avulsion fracture of the base of the fifth metatarsal happens when the ankle is twisted inwards. When the ankle is twisted inwards a muscle called the fibularis brevis contracts to stop the movement and protect the ligaments of the ankle. The base of the fifth metatarsal is where this muscle is attached. The group of lateral leg muscles that function to plantarflex the foot includes the fibularis brevis and the fibularis longus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 23
Correct
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Which of the following statements is correct regarding homeostasis?
Your Answer: In negative feedback mechanisms, effectors always act to move the variable in the opposite direction to the change that was originally detected.
Explanation:The vast majority of systems within the body work by negative feedback mechanisms. This negative feedback refers to the way that effectors act to move the variable in the opposite direction to the change that was originally detected. Because there is an inherent time delay between detecting a change in a variable and effecting a response, the negative feedback mechanisms cause oscillations in the variable they control. There is a narrow range of values within which a normal physiological function occurs and this is called the ‘set point’. The release of oxytocin in childbirth is an example of positive feedback.
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This question is part of the following fields:
- Basic Cellular
- Physiology
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Question 24
Incorrect
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Which of the following is NOT a common side effect of amiodarone:
Your Answer: Pulmonary fibrosis
Correct Answer: Blue/green teeth discolouration
Explanation:Common side effects of amiodarone include: Bradycardia, Nausea and vomiting, Thyroid disorders – hypothyroidism and hyperthyroidism, Persistent slate grey skin discoloration, Photosensitivity, Pulmonary toxicity (including pneumonitis and fibrosis), Hepatotoxicity, Corneal microdeposits (sometimes with night glare), Peripheral neuropathy and Sleep disorders.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 25
Incorrect
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An elderly man with chronic heart and lung disease develops Legionnaires' Disease. By what route was the infection most likely to have been acquired:
Your Answer: Exposure to livestock or animal products
Correct Answer: Inhalation of aerosolised contaminated water
Explanation:Legionella pneumophilais a Gram negative bacterium that is found in natural water supplies and in the soil, transmitted predominantly via inhalation of aerosols generated from contaminated water (direct person-to-person spread of infected patients does not occur). It is the cause of Legionnaires’ disease. Outbreaks of Legionnaires’ disease have been linked to poorly maintained air conditioning systems, whirlpool spas and hot tubs.The clinical features of the pneumonic form of Legionnaires’ disease include:Mild flu-like prodrome for 1-3 daysCough (usually non-productive and occurs in approximately 90%)Pleuritic chest painHaemoptysisHeadacheNausea, vomiting and diarrhoeaAnorexiaLegionella pneumophilainfections can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used.The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur with Legionnaires’ disease and will result in hyponatraemia as is seen in this case.Legionella pneumophilainfections are resistant to amoxicillin but can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used. The majority of cases of Legionnaires’ disease are caused by Legionella pneumophila, however many other species of Legionella have been identified.Legionella longbeachae is another less commonly encountered species that has also been implicated in outbreaks. It is predominantly found in soil and potting compost, and has caused outbreaks of Pontiac fever, the non-respiratory and less severe variant of Legionnaires’ disease.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 26
Incorrect
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A 62-year-old man complains of chest pain and goes to the emergency room. You diagnose him with an acute coronary syndrome and prescribe enoxaparin as part of his treatment plan.Enoxaparin inactivates which of the following?
Your Answer: Factor IX
Correct Answer: Thrombin
Explanation:Enoxaparin is a low molecular weight heparin (LMWH) that works in the same way as heparin by binding to and activating the enzyme inhibitor antithrombin III. Antithrombin III inactivates thrombin by forming a 1:1 complex with it. Factor Xa and a few other clotting proteases are also inhibited by the heparin-antithrombin III complex.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 27
Correct
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Naloxone is a reversal agent for which of the following groups of drugs:
Your Answer: Opioids
Explanation:Naloxone is a specific antagonist of mu(μ)-opioid receptors, the specific antidote for opioid overdose and will reverse respiratory depression and coma if given at sufficient dosage. The initial dose is usually 0.8 mg (2 mL) intravenously (the dose range suggested by BNF is 0.4-2 mg). It can also be given by intramuscular injection if the intravenous route is not feasible.As naloxone has a shorter duration of action than most opioids, close monitoring and repeated injections are necessary according to the respiratory rate and depth of coma. The dose is generally repeated every 2-3 minutes to a maximum of 10 mg. When repeated doses are needed, naloxone may be given by a continuous infusion adjusted according to the vital signs. Initially, the infusion rate can be set at 60% of the initial resuscitative IV dose per hour.In opioid addicts, naloxone administration may precipitate a withdrawal syndrome with abdominal cramps, nausea and diarrhoea, but these usually settle within 2 hours.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 28
Incorrect
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When treating diabetic ketoacidosis (DKA), which of the following should be given if the systolic blood pressure is initially less than 90 mmHg:
Your Answer: 1 L sodium chloride 0.9% intravenous infusion over 10 - 15 minutes
Correct Answer: 500 mL sodium chloride 0.9% intravenous infusion over 10 - 15 minutes
Explanation:If SBP is less than 90 mmHg , 500 mL sodium chloride 0.9 percent should be administered intravenously over 10–15 minutes, and repeated if SBP remains less than 90 mmHg. When SBP is greater than 90 mmHg, sodium chloride infusion must be maintained at a rate that replaces the deficit.
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This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 29
Incorrect
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Regarding control of hospital acquired infection (HAI), which of the following statements is CORRECT:
Your Answer: Disinfection is the inactivation of all infectious agents.
Correct Answer: Chlorhexidine is an anti-staphylococcal agent.
Explanation:Chlorhexidine is an anti-staphylococcal agent. Cleaning is the removal of foreign material from areas or objects to a point at which they are visually free from debris. Disinfection is the reduction in the number of infectious particles. Isopropyl alcohol is not effective against C. difficile spores. Autoclaving is a method of sterilisation.
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This question is part of the following fields:
- Microbiology
- Principles
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Question 30
Incorrect
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A 23-year-old student presents to the emergency department with a terrible headache, photophobia, and a fever. On her lower limbs, you see a non-blanching purpuric rash. In the department, a lumbar puncture is conducted. What do you think you'll notice on Gram stain:
Your Answer: Gram positive diplococci
Correct Answer: Gram negative diplococci
Explanation:Bacterial meningitis and septicaemia are most commonly caused by meningococcal bacteria. The Gram-negative diplococci Neisseria Meningitidis causes meningitis. Gram stain and culture of CSF identify the etiologic organism, N meningitidis. In bacterial meningitis, Gram stain is positive in 70-90% of untreated cases, and culture results are positive in as many as 80% of cases.
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This question is part of the following fields:
- Infections
- Microbiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
