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  • Question 1 - Which patient group are most commonly associated with infection with Klebsiella spp: ...

    Correct

    • Which patient group are most commonly associated with infection with Klebsiella spp:

      Your Answer: Hospitalised patients

      Explanation:

      Klebsiella spp. are facultatively anaerobic Gram-negative rods, found in the normal intestinal and respiratory flora. These organisms are usually opportunistic pathogens that cause nosocomial infections, most commonly pneumonia and UTI.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      19.9
      Seconds

  • Question 2 - Regarding Clostridium tetani, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Infection is predominantly derived from animal faeces and soil.

      Explanation:

      Clostridium tetaniis a Gram positive, rod shaped, obligate anaerobic bacterium.The incubation period is quoted as anywhere between 4-21 days and can occur after several months but symptoms usually occur within the first 7 days after exposure.Approximately 80% of patients develop generalised tetanus. The commonest presenting feature of generalised tetanus is trismus (lockjaw), occurring in approximately 75% of affected individuals. Other clinical features include:Facial spasms (risus sardonicus)Opisthotonus (characteristic body shape during spasms)Neck stiffnessDysphagiaCalf and pectoral muscle rigidityFeverHypertensionTachycardiaSpasms can occur frequently and last for several minutes, they can continue to occur for up to 4 weeks. Current mortality rates are between 10 and 15%.Tetanic spasms are caused by the exotoxin tetanospasmin. The effects of tetanolysin are not fully understood but it is not believed to have clinical significance.Localised tetanus is a rare form of the disease, occurring in around 1% of affected individuals. Patients have persistent contraction of muscles in the same anatomic area as the injury. It may precede generalised tetanus.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 3 - For the treatment of his atrial fibrillation, a 59-year-old man is about to...

    Incorrect

    • For the treatment of his atrial fibrillation, a 59-year-old man is about to begin taking warfarin. He also takes a number of other medications.Which of the following medications will enhance warfarin's effects?

      Your Answer:

      Correct Answer: Erythromycin

      Explanation:

      Many medications, including warfarin, require cytochrome P450 enzymes for their metabolism. When co-prescribing cytochrome p450 enzyme inducers and inhibitors with warfarin, it’s critical to be cautious.Inhibitors of the cytochrome p450 enzyme potentiate the effects of warfarin, resulting in a higher INR. To remember the most commonly encountered cytochrome p450 enzyme inhibitors, use the mnemonic O DEVICES:O– OmeprazoleD– DisulfiramE– Erythromycin (And other macrolide antibiotics)V– Valproate (sodium valproate)I– IsoniazidC– CiprofloxacinE– Ethanol (acute ingestion)S- Sulphonamides

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 4 - A patient presents to your Emergency Department with a laceration on their buttocks...

    Incorrect

    • A patient presents to your Emergency Department with a laceration on their buttocks requiring closure with sutures.What stage of wound healing is the first to reach completion?

      Your Answer:

      Correct Answer: Haemostasis

      Explanation:

      The stages of wound healing are: haemostasis, inflammatory, proliferative and remodelling (maturation) phases in that order. The first stage in the healing process of a laceration is haemostasis. Haemostasis is the process of the wound being closed by clotting. The inflammatory phase occurs just after and up to 48 hours after injury– Blood vessels dilate to allow white blood cells, antibodies, growth factors, enzymes and nutrients to reach the wounded area leading to the characteristic signs of inflammation seen. Epithelialisation and angiogenesis are not phases of wound healing but occur during the proliferative phase. This ia after haemolysis and inflammation phases have occurred.The maturation phase is the final phase and occurs when the wound has closed. It involves remodelling of collagen from type III to type I. Apoptosis remove unwanted cells, cellular activity reduces and the number of blood vessels in the wounded area regresses and decreases. This can continues for up to 1 year after injury.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds

  • Question 5 - At which vertebral level does the spinal cord normally end in adults? ...

    Incorrect

    • At which vertebral level does the spinal cord normally end in adults?

      Your Answer:

      Correct Answer: L1/L2

      Explanation:

      The spinal cord starts at the foramen magnum, where it is continuous with the medulla oblongata, which is the most caudal portion of the brainstem.It then extends inferiorly through the vertebral canal. In adults, it usually ends at the level of the first or second lumbar vertebra.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds

  • Question 6 - The correct statement regarding the parasympathetic nervous system is which of the following?...

    Incorrect

    • The correct statement regarding the parasympathetic nervous system is which of the following?

      Your Answer:

      Correct Answer: Parasympathetic preganglionic neurones run in cranial nerves III, VII, IX and X.

      Explanation:

      The electron transfer system is responsible for most of the energy produced during respiration. The is a system of hydrogen carriers located in the inner mitochondrial membrane. Hydrogen is transferred to the electron transfer system via the NADH2 molecules produced during glycolysis and the Krebs cycle. As a result, a H+ion gradient is generated across the inner membrane which drives ATP synthase. The final hydrogen acceptor is oxygen and the H+ions and O2 combine to form water.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 7 - Many of the chemical digestion and absorption takes place in the small intestine....

    Incorrect

    • Many of the chemical digestion and absorption takes place in the small intestine. Most digestive enzymes in the small intestine are secreted by the pancreas and enter the small intestine through the pancreatic duct.Which of these digestive enzymes is responsible for breaking down carbohydrates into monosaccharides?

      Your Answer:

      Correct Answer: Glucoamylase

      Explanation:

      Majority of carbohydrates are broken down into monosaccharides (glucose, fructose galactose) and are absorbed by the small intestine. Enzymes released from the brush border break down carbohydrate. Some carbohydrates, such as cellulose, are not digested at all, despite being made of multiple glucose units. This is because the cellulose is made out of beta-glucose that makes the inter-monosaccharide bindings different from the ones present in starch, which consists of alpha-glucose. Humans lack the enzyme for splitting the beta-glucose-bond.The principal brush border enzymes are dextranase and glucoamylase. Other brush border enzymes are maltase, sucrase, and lactase.Pancreatic amylase breaks down some carbohydrates (notably starch) into oligosaccharides. Dextranase and glucoamylase, then further break down oligosaccharides.Trypsin aids in digestion of protein.Chymotrypsin is a proteolytic enzyme that digests proteinCarboxypeptidase hydrolyses the first peptide or amide bond at the carboxyl or C-terminal end of proteins and peptides

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      0
      Seconds

  • Question 8 - Which of the following cervical nerves is likely to be affected if your...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds

  • Question 9 - A 42-year-old male patient, presenting with polyuria and polydipsia symptoms had normal blood...

    Incorrect

    • A 42-year-old male patient, presenting with polyuria and polydipsia symptoms had normal blood test results. Upon interview, he had mentioned being in a car accident in which he had a head injury. His polyuria and polydipsia symptoms are most likely associated with which of the following conditions?

      Your Answer:

      Correct Answer: Cranial diabetes insipidus

      Explanation:

      Polydipsia is the feeling of extreme thirstiness. It is often linked to polyuria, which is a urinary condition that causes a person to urinate excessively. The cycle of these two processes makes the body feel a constant need to replace the fluids lost in urination. In healthy adults, a 3 liter urinary output per day is considered normal. A person with polyuria can urinate up to 15 liters of urine per day. Both of these conditions are classic signs of diabetes. The other options are also types of diabetes, except for psychogenic polydipsia (PPD), which is the excessive volitional water intake seen in patients with severe mental illness or developmental disability. However, given the patient’s previous head injury, the most likely diagnosis is cranial diabetes insipidus. By definition, cranial diabetes insipidus is caused by damage to the hypothalamus or pituitary gland after an infection, operation, brain tumor, or head injury. And the patient’s history confirms this diagnosis. To define the other choices, nephrogenic diabetes insipidus happens when the structures in the kidneys are damaged and results in an inability to properly respond to antidiuretic hormone. Kidney damage can be caused by an inherited (genetic) disorder or a chronic kidney disorder. As with cranial diabetes insipidus, nephrogenic diabetes insipidus can also cause an elevated urine output. Diabetes mellitus is classified into two types, and the main difference between them is that type 1 diabetes is a genetic disorder, and type 2 diabetes is diet-related and develops over time. Type 1 diabetes is also known as insulin-dependent diabetes, in which the pancreas produces little or no insulin. Type 2 diabetes is termed insulin resistance, as cells don’t respond customarily to insulin.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      0
      Seconds

  • Question 10 - Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic...

    Incorrect

    • Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels. The phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.A phenylalkylamine calcium-channel blocker is, for example, which of the following?

      Your Answer:

      Correct Answer: Verapamil

      Explanation:

      Calcium-channel blockers, also known as calcium antagonists, stop calcium from entering cells through the L-type calcium channel. This causes vascular smooth muscle in vessel walls to relax, resulting in a decrease in peripheral vascular resistance. They can be used for a variety of things, including:HypertensionAnginaAtrial fibrillationMigraineCalcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels.Dihydropyridines have a high vascular selectivity and lower systemic vascular resistance and blood pressure. As a result, they’re frequently used to treat hypertension. Modified release formulations are also used to treat angina, but their powerful systemic vasodilator and pressure-lowering effects can cause reflex cardiac stimulation, resulting in increased inotropy and tachycardia, which can counteract the beneficial effects of reduced afterload on myocardial oxygen demand.The suffix -dpine distinguishes dihydropyridines from other pyridines. Examples of dihydropyridines that are commonly prescribed include:AmlodipineFelodipineNifedipineNimodipineThe phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.Phenylalkylamines are less effective as systemic vasodilators because they are relatively selective for the myocardium. This group of drugs lowers myocardial oxygen demand and reverses coronary vasospasm, making them useful in the treatment of angina. They are also occasionally used to treat arrhythmias. A phenylalkylamine calcium-channel blocker like verapamil is an example.In terms of selectivity for vascular calcium channels, benzothiazepines fall somewhere between dihydropyridines and phenylalkylamines. They can lower arterial pressure without producing the same level of reflex cardiac stimulation as dihydropyridines because they have both cardiac depressant and vasodilator effects. Diltiazem is the only benzothiazepine currently in clinical use.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 11 - A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited...

    Incorrect

    • A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited range of motion in the right elbow for the past two days. On examination, the right elbow is extremely tender with erythema and warmth of the overlying skin due to acute inflammation. Which ONE of the following statements is true with regards to acute inflammation?

      Your Answer:

      Correct Answer: Neutrophils are activated and adhere to the endothelium as a result of interaction with endothelial cell adhesion molecules

      Explanation:

      Acute inflammation is defined as inflammation occurring within minutes to hours in response to an injury lasting for less than two weeks. Acute inflammation Rapid onset (minutes to hours)Quick resolution (usually days)Chronic inflammationMay last weeks, months, or yearsThere are five cardinal signs of inflammation:1) Pain2) Redness3) Warmth4) Oedema5) Loss of functionDuring acute inflammation, neutrophils are activated and attracted to the site of inflammation in response to various interleukins and cytokines. This process takes place via the following mechanism:1) MarginationNeutrophils flow nearer the vessel wall rather than in the axial stream, which is referred to as margination2) Rolling along the surface of vascular endothelium3) Adhesion to the endothelium by interaction with adhesion molecules (ICAMS and VCAMS)4) Diapedesis is the movement of neutrophils from the endothelial cells into the interstitial space by squeezing through the gaps between adjacent endothelial cellsBradykinin and histamine are both responsible for vasodilation which causes oedema and decreases intravascular osmotic pressure.Neutrophils dominate early (2 days)- Live longer- Replicate in tissues

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds

  • Question 12 - What does the correlation coefficient r = 0 indicate with regards to linear...

    Incorrect

    • What does the correlation coefficient r = 0 indicate with regards to linear relationships between two variables?

      Your Answer:

      Correct Answer: There is no correlation between two variables

      Explanation:

      r = 0 if there is no correlation between two variables. The closer that r is to 0, the weaker the correlation.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds

  • Question 13 - Which statement about cross-sectional studies is true? ...

    Incorrect

    • Which statement about cross-sectional studies is true?

      Your Answer:

      Correct Answer: They can be used to assess the prevalence of a condition

      Explanation:

      Cross-sectional studies can be used to assess the prevalence of a condition.Cross-sectional studies CANNOT be used to differentiate between cause and effect or establish the sequence of events.They can be used to study multiple outcomes but are NOT suitable for studying rare diseases.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds

  • Question 14 - A 55 year old man presents to ED complaining of leg weakness. Your...

    Incorrect

    • A 55 year old man presents to ED complaining of leg weakness. Your colleague has examined the patient and suspects femoral nerve palsy. Which of the following clinical features would you LEAST expect to see on examination of this patient:

      Your Answer:

      Correct Answer: Weakness of hip extension

      Explanation:

      Damage to the femoral nerve results in weakness of hip flexion and knee extension and loss of sensation over the anterior thigh and the anteromedial knee, medial leg and medial foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 15 - An 80-year-old male has presented with chest pain characteristic of angina pectoris. Before...

    Incorrect

    • An 80-year-old male has presented with chest pain characteristic of angina pectoris. Before initiating treatment with Glyceryl nitrate, you examine the patient and find a murmur. The patient reveals that he has a heart valve disorder, and you immediately put a hold on the GTN order.Which of the following valve disorders is an absolute contraindication to the use of GTN?

      Your Answer:

      Correct Answer: Mitral stenosis

      Explanation:

      Angina pectoris is the most common symptom of ischemic heart disease and presents with chest pain relieved by rest and nitro-glycerine. Nitrates are the first-line treatment to relieve chest pain caused by angina. The commonly used nitrates are: 1. Nitro-glycerine (NTG) – angina pectoris (treatment/prophylaxis), acute coronary syndrome, heart failure, hypertension2. Isosorbide mononitrate (ISMN) – chronic angina pectoris (treatment)3. Isosorbide dinitrate (ISDN) – angina pectoris (treatment/prophylaxis)The nitrate drugs cause vasodilation via the action of nitric oxide. The contraindications to the use of nitrate are the following: 1. Allergy to nitrates2. Concomitant use of phosphodiesterases (PDE) inhibitors such as tadalafil and sildenafil3. Right ventricular infarction4. Hypertrophic cardiomyopathy5. Cardiac tamponade6. Constrictive pericarditis7. Hypotensive conditions8. Hypovolaemia9. Marked anaemia10. Mitral stenosis11. Raised intracranial pressure due to cerebral haemorrhage or head trauma12. Toxic pulmonary oedema

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 16 - Dysuria and urinary frequency are symptoms of a 29-year-old woman. A urine dipstick...

    Incorrect

    • Dysuria and urinary frequency are symptoms of a 29-year-old woman. A urine dipstick is used to detect the presence of blood, protein, leucocytes, and nitrites in the urine. You diagnose a urinary tract infection and give antibiotics to the patient.In the United Kingdom, which of the following antibiotics has the highest percentage of E.coli resistance?

      Your Answer:

      Correct Answer: Trimethoprim

      Explanation:

      In the United Kingdom, antibiotic resistance is becoming a significant factor in the treatment of urinary tract infections and pyelonephritis. E. coli (the main causative organism of both urinary tract infections and acute pyelonephritis) resistance to the following antibiotics in laboratory-processed urine specimens is:30.3 percent trimethoprim (varies by area from 27.1 to 33.4 percent )19.8 percent co-amoxiclav (varies by area from 10.8 to 30.7 percent )Ciprofloxacin (Cipro): 10.6% (varies by area from 7.8 to 13.7 percent )Cefalexin has a concentration of 9.9%. (varies by area from 8.1 to 11.4 percent )

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 17 - During anaerobic respiration, what is the net generation of ATP molecules: ...

    Incorrect

    • During anaerobic respiration, what is the net generation of ATP molecules:

      Your Answer:

      Correct Answer: 2

      Explanation:

      In anaerobic respiration, two ATP molecules are produced for every glucose molecule, as opposed to the 38 molecules of ATP produced in aerobic respiration.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 18 - Regarding the human cell, which of the following cell organelles is responsible for...

    Incorrect

    • Regarding the human cell, which of the following cell organelles is responsible for the production of ATP:

      Your Answer:

      Correct Answer: Mitochondria

      Explanation:

      Mitochondria are membrane-bound organelles that are responsible for the production of the cell’s supply of chemical energy. This is achieved by using molecular oxygen to utilise sugar and small fatty acid molecules to generate adenosine triphosphate (ATP). This process is known as oxidative phosphorylation and requires an enzyme called ATP synthase. ATP acts as an energy-carrying molecule and releases the energy in situations when it is required to fuel cellular processes. Mitochondria are also involved in other cellular processes, including Ca2+homeostasis and signalling. Mitochondria contain a small amount of maternal DNA.Mitochondria have two phospholipid bilayers, an outer membrane and an inner membrane. The inner membrane is intricately folded inwards to form numerous layers called cristae. The cristae contain specialised membrane proteins that enable the mitochondria to synthesise ATP. Between the two membranes lies the intermembrane space, which stores large proteins that are required for cellular respiration. Within the inner membrane is the perimitochondrial space, which contains a jelly-like matrix. This matrix contains a large quantity of ATP synthase.Mitochondrial disease, or mitochondrial disorder, refers to a group of disorders that affect the mitochondria. When the number or function of mitochondria in the cell are disrupted, less energy is produced and organ dysfunction results.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 19 - All of the following are indications for beta-blockers EXCEPT for: ...

    Incorrect

    • All of the following are indications for beta-blockers EXCEPT for:

      Your Answer:

      Correct Answer: Prinzmetal's angina

      Explanation:

      Beta-blockers are contraindicated in Prinzmetal’s angina.Beta-blockers may be indicated in:HypertensionPheochromocytoma (only with an alpha-blocker)AnginaSecondary prevention after ACSArrhythmias including atrial fibrillationHeart failureThyrotoxicosisAnxietyProphylaxis of migraineEssential tremorGlaucoma

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

  • Question 20 - Which of the following is NOT a common side effect of diazepam: ...

    Incorrect

    • Which of the following is NOT a common side effect of diazepam:

      Your Answer:

      Correct Answer: Bradycardia

      Explanation:

      Adverse effects include:Drowsiness and lightheadednessConfusion and ataxia (especially in the elderly), amnesia, muscle weaknessHeadache, vertigo, tremor, dysarthria, hypotension, decreased libido, erectile dysfunction, gynaecomastia, urinary retentionParadoxical effects such as talkativeness, excitement, irritability, aggression, anti-social behaviour, and suicidal ideationWithdrawal symptoms, for example anxiety, depression, anorexia, impaired concentration, insomnia, abdominal cramps, palpitations, tremor, tinnitus and perceptual disturbancesTolerance and dependence (people who use benzodiazepines longer term can develop tolerance and eventual dependence)

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 21 - A 22-year-old student presents with severe headache accompanied with nausea and vomiting. Upon...

    Incorrect

    • A 22-year-old student presents with severe headache accompanied with nausea and vomiting. Upon observation and examination, it was noted that he is febrile and Kernig's sign is positive. A diagnosis of meningitis was suspected and a lumbar puncture was to be performed.Which of the following statements regarding meningitis is true?

      Your Answer:

      Correct Answer: The dura mater is the outermost layer

      Explanation:

      Meningitis is defined as the inflammation of the meninges due to an infection caused by a bacteria or a virus. Symptoms usually include stiffness of the neck, headache, and fever. There are 3 meningeal layers that surround the spinal cord and they are the dura mater, arachnoid matter, and pia mater. The dura mater is the outermost and thickest layer out of all the 3 layers. The arachnoid atter is the middle layer, and is very thin.The third and deepest meningeal layer is the pia mater that is bound tightly to the surface of the spinal cord.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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      Seconds

  • Question 22 - Which of these structures is the smallest and deepest component of muscle connective...

    Incorrect

    • Which of these structures is the smallest and deepest component of muscle connective tissue?

      Your Answer:

      Correct Answer: Endomysium

      Explanation:

      There are three types of muscle:Skeletal muscleCardiac muscleSmooth muscleIndividual muscle is enveloped in a layer of dense irregular connective tissue called the epimysium. The epimysium protects the muscles from friction against bones and other muscles.Skeletal muscle is composed of muscle fibres, referred to as myofibers which is ensheathed by a wispy layer of areolar connective tissue called the endomysium. The endomysium is the smallest and deepest component of muscle connective tissue. Myofibers grouped together in bundles form fascicles, or fasciculi. These are surrounded by a type of connective tissue called the perimysium.Beneath the endomysium lies the sarcolemma, an elastic sheath with infoldings that invaginate the interior of the myofibers, particularly at the motor endplate of the neuromuscular junction.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
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  • Question 23 - Parasympathetic preganglionic neurons originate in which of the following locations: ...

    Incorrect

    • Parasympathetic preganglionic neurons originate in which of the following locations:

      Your Answer:

      Correct Answer: Brainstem and pelvic splanchnic nerves

      Explanation:

      Parasympathetic preganglionic neurones originate in the brainstem from which they run in cranial nerves III, VII, IX and X and also from the second and third sacral segments of the spinal cord. Parasympathetic preganglionic neurones release acetylcholine into the synapse, which acts on cholinergic nicotinic receptors on the postganglionic fibre. Parasympathetic peripheral ganglia are generally found close to or within their target, whereas sympathetic peripheral ganglia are located largely in two sympathetic chains on either side of the vertebral column (paravertebral ganglia), or in diffuse prevertebral ganglia of the visceral plexuses of the abdomen and pelvis. Parasympathetic postganglionic neurones release acetylcholine, which acts on cholinergic muscarinic receptors.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
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  • Question 24 - A 32 year old man is brought to ED having been thrown off...

    Incorrect

    • A 32 year old man is brought to ED having been thrown off his motorbike. Following initial resuscitation and ruling out life-threatening injuries, you establish the patient has weakness of hip flexion. Which of the following nerves has most likely been injured:

      Your Answer:

      Correct Answer: Femoral nerve

      Explanation:

      Flexion of the hip is produced by the iliacus, the psoas major, the sartorius, rectus femoris and the pectineus muscles. The femoral nerve innervates the iliacus, pectineus, sartorius and quadriceps femoris muscles, and supplies skin on the anterior thigh, anteromedial knee and medial leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 25 - A patient with abdominal pain, vomiting and bloody diarrhoea develops a low platelet...

    Incorrect

    • A patient with abdominal pain, vomiting and bloody diarrhoea develops a low platelet count and deranged renal function. A diagnosis of haemolytic uraemic syndrome is made.Which of the following organisms is a recognised cause of haemolytic uraemic syndrome? Select ONE answer only.

      Your Answer:

      Correct Answer: Escherichia coli

      Explanation:

      E.Colistrain 0157 causes enterohaemorrhagic diarrhoea and can be followed by haemolytic uraemic syndrome (renal failure, haemolytic anaemia and thrombocytopenia).

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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  • Question 26 - A 66-year-old male is brought to your clinic by his wife with the...

    Incorrect

    • A 66-year-old male is brought to your clinic by his wife with the complaint of increasing confusion and disorientation over the past three days, along with decreased urination. She reports that he has been complaining of increasing pain in his back and ribs over the past three months. On examination, the patient looks anaemic, is not oriented in time, place and person and has tenderness on palpation of the lumbar spine and the 10th, 11th and 12th ribs. Blood tests show anaemia which is normocytic, normochromic, raised urea and creatinine and hypercalcemia. Which one of the following diagnoses is most likely in this case?

      Your Answer:

      Correct Answer: Multiple myeloma

      Explanation:

      Multiple myeloma is a clonal abnormality affecting plasma cells in which there is an overproduction of functionless immunoglobulins. The most common patient complaint is bone pain, especially in the back and ribs. Anaemia and renal failure are common, along with hypercalcemia. Hypercalcemia may lead to an altered mental status, as in this case. Chronic lymphocytic leukaemia occurs due to the overproduction of lymphocytes, usually B cells. CLL may present with an asymptomatic elevation of B cells. Patients are generally more than 50 years old and present with non-specific fatigue and weight loss symptoms.There is no history of alcohol abuse in this case. Furthermore, patients with a history of alcohol abuse may have signs of liver failure, which are not present here. Metastatic prostate cancer would most often cause lower backache as it metastasises first to the lumbar spine via the vertebral venous plexus. A patient with Vitamin B12 deficiency would have anaemia, megaloblastic, hypersegmented neutrophils, and signs of peripheral neuropathy.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 27 - You're in resus with a 69-year-old woman who is very sick. You decide...

    Incorrect

    • You're in resus with a 69-year-old woman who is very sick. You decide to contact the intensive care outreach team because she appears to be in septic shock. They decide to start a dobutamine infusion as soon as they arrive.Which of the following statements about dobutamine is correct?

      Your Answer:

      Correct Answer: It may be infused via a peripheral line

      Explanation:

      Dobutamine is a synthetic isoprenaline derivative that is used to provide inotropic support to patients with low cardiac output caused by septic shock, myocardial infarction, or other cardiac conditions.Dobutamine is a sympathomimetic drug that stimulates beta-1 adrenergic receptors in the heart to produce its primary effect. As a result, it has inotropic properties that increase cardiac contractility and output. It also has a small amount of alpha1- and beta-2-adrenergic activity.It is infused intravenously after being diluted to a volume of at least 50 ml in a suitable crystalloid solution. The dose is titrated to response and ranges from 0.5 to 40 g/kg/min. Extravasation-induced skin necrosis is uncommon, and dobutamine can be administered through a peripheral line.At doses below 10 g/kg/min, side effects are rare, but at higher doses, they can include:Nausea and vomitingTachycardiaDysrhythmiasAnginaHypertensionHeadache

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 28 - A 26-year-old male presents to your clinic with the complaint of recurrent fevers...

    Incorrect

    • A 26-year-old male presents to your clinic with the complaint of recurrent fevers over the past three months. On documentation of the fever, it is noted that the fever increases and decreases in a cyclical pattern over a 1-2 week period. After the appropriate investigations, a diagnosis of Pel-Ebstein fever is made. Which ONE of the following conditions is most likely to cause this patient's fever?

      Your Answer:

      Correct Answer: Hodgkin lymphoma

      Explanation:

      The release of cytokines from Reed-Sternberg cells can cause fever in patients with Hodgkin lymphoma, which increases and decreases in a cyclical pattern of 1 to 2 weeks. This is called Pel-Ebstein or Ebstein-Cardarelli fever, specifically seen in Hodgkin lymphoma. The fever is always high grade and can reach 40 degrees or higher.Cyclical fever in other conditions is common but is not termed as Pel-Ebstein fever. This term is reserved only with Hodgkin lymphoma.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 29 - A 59-year-old otherwise well woman presents with a history of polydipsia and polyuria....

    Incorrect

    • A 59-year-old otherwise well woman presents with a history of polydipsia and polyuria. There is a past history of kidney stones, and blood tests done reveal the following: Na: 147 mmol/L (135-147 mmol/L) K: 4.0 mmol/L (3.5-5.5 mmol/L) Urea: 7.3 mmol/L (2.0-6.6 mmol/L) Creatinine: 126 mmol/L (75-125 mmol/L) Fasting blood glucose: 5.0 mmol/L (3.4-5.5 mmol/L) Corrected calcium: 3.21 mmol/L (2.05-2.60 mmol/L) Phosphate: 0.70 mmol/L (0.8-1.4 mmol/L) Parathyroid hormone: 189 ng/L (10-60 ng/L)The most likely diagnosis is?

      Your Answer:

      Correct Answer: Primary hyperparathyroidism

      Explanation:

      ​Primary hyperparathyroidism the commonest cause of hypercalcaemia. It is commonest in women aged 50 to 60.The commonest cause of primary hyperparathyroidism is a solitary adenoma of the parathyroid gland (approximately 85% of cases). Primary hyperparathyroidism may present with features of hypercalcaemia such as polyuria, polydipsia, renal stones, bone and joint pain, constipation, and psychiatric disorders.In primary Hyperparathyroidism:PTH is elevatedCalcium is elevatedPhosphate is loweredIn secondary Hyperparathyroidism:PTH is elevatedCalcium is low or low-normalPhosphate is raised in CRFIn tertiary Hyperparathyroidism:PTH is elevatedCalcium is elevatedPhosphate is lowered in CRF

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
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  • Question 30 - A 32-year-old woman diagnosed with hyperthyroidism has her T 4 levels grossly elevated...

    Incorrect

    • A 32-year-old woman diagnosed with hyperthyroidism has her T 4 levels grossly elevated and she is started on carbimazole.A release of which of the following from the hypothalamus is inhibited by increase in T4 levels?

      Your Answer:

      Correct Answer: Thyrotropin-releasing hormone

      Explanation:

      A negative feedback mechanism involving the hypothalamic-pituitary-thyroid axis controls the release of T3 and T4 into the bloodstream. When metabolic rate is low or serum T3 and/or T4 levels are decrease, this triggers the secretion of thyrotropin-releasing hormone (TRH) from the hypothalamus.TRH goes to the anterior pituitary gland and stimulates secretion of thyroid-stimulating hormone (TSH). An increased serum level of T3 and T4 inhibits the release of TRH.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
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Microbiology (1/1) 100%
Pathogens (1/1) 100%
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