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  • Question 1 - Which of the following nerves is responsible for the symptoms of a patient...

    Incorrect

    • Which of the following nerves is responsible for the symptoms of a patient with history of recurrent herpes simplex outbreaks on his face and presents with ophthalmic herpes zoster and a painful vesicle on the tip of his nose?

      Your Answer: Inferior palpebral nerve

      Correct Answer: Nasociliary nerve

      Explanation:

      Hutchinson sign relates to involvement of the tip of the nose from facial herpes zoster. It implies involvement of the external nasal branch of the nasociliary nerve which is a branch of the ophthalmic division of the trigeminal nerve. The nasociliary branch of the trigeminal nerve innervates the apex and lateral aspect of the nose, as well as the cornea. Therefore, lesions on the side or tip of the nose should raise suspicion of ocular involvement.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      27.1
      Seconds
  • Question 2 - Which of the following is the most abundant peripheral blood leucocyte: ...

    Correct

    • Which of the following is the most abundant peripheral blood leucocyte:

      Your Answer: Neutrophils

      Explanation:

      Neutrophils are the most abundant peripheral blood leucocyte, comprising about 50 – 70% of circulating white cells. Neutrophils have a characteristic dense nucleus consisting of between two and five lobes, and a pale cytoplasm with an irregular outline containing many fine pink-blue or grey-blue granules. The granules are divided into primary, which appear at the promyelocyte stage, and secondary, which appear at the myelocyte stage and predominate in the mature nucleus. Both types of granule are lysosomal in origin; the primary contains myeloperoxidase and other acid hydrolases; the secondary contains lactoferrin, lysozyme and other enzymes. The lifespan of neutrophils in the blood is only 6 – 10 hours. In response to tissue damage, cytokines and complement proteins, neutrophils migrate from the bloodstream to the site of insult within minutes, where they destroy pathogens by phagocytosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      5.2
      Seconds
  • Question 3 - An 18-year-old student presents with a 1-week history of sore throat, low grade...

    Correct

    • An 18-year-old student presents with a 1-week history of sore throat, low grade fever, and malaise. Upon history taking, she noted that she had a fine rash over her body a week ago that quickly fades. Further examination and observation was done and the presence of mild splenomegaly was noted. Her test shows positive for heterophile antibody test, suspecting a diagnosis of infectious mononucleosis.Which of the following characteristics is mostly associated with the diagnosis of infectious mononucleosis?

      Your Answer: Atypical lymphocytes

      Explanation:

      Epstein-Barr virus causes infectious mononucleosis which is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue and fever. It is accompanied by atypical large peripheral blood lymphocytes. These atypical lymphocytes, also known as Downey cells, are actually activated CD8 T lymphocytes, most of which are responding to EBV-infected cells.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      150.4
      Seconds
  • Question 4 - A 35 year old patient presents to ED having sustained an injury to...

    Incorrect

    • A 35 year old patient presents to ED having sustained an injury to his right hand whilst playing cricket. He is unable to fully straighten his right middle finger as the distal phalanx remains flexed. Which of the following structures within the digit was most likely injured:

      Your Answer: Insertion of central slip of extensor digitorum tendon

      Correct Answer: Insertion of terminal extensor digitorum tendon

      Explanation:

      Damage to the insertion of the terminal extensor digitorum tendon would result in loss of extension at the distal interphalangeal joint causing a fixed flexion deformity, called the Mallet deformity.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      27.4
      Seconds
  • Question 5 - A 32 year old man is brought to ED having been thrown off...

    Correct

    • 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: 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
      22.8
      Seconds
  • Question 6 - A 22-year-old man arrives at the emergency department with a sore throat, low-grade...

    Incorrect

    • A 22-year-old man arrives at the emergency department with a sore throat, low-grade fever, and malaise. His partner has infectious mononucleosis, which was recently diagnosed. In this situation, which of the following cells is the most proliferative:

      Your Answer: Monocytes

      Correct Answer: Lymphocytes

      Explanation:

      Histologic findings in EBV infectious mononucleosis: Oropharyngeal epithelium demonstrates an intense lymphoproliferative response in the cells of the oropharynx. The lymph nodes and spleen show lymphocytic infiltration primarily in the periphery of a lymph node.Relative lymphocytosis (≥ 60%) plus atypical lymphocytosis (≥ 10%) are the characteristic findings of Epstein Barr virus (EBV) infectious mononucleosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      39.1
      Seconds
  • Question 7 - Hartmann's solution contains how much sodium: ...

    Incorrect

    • Hartmann's solution contains how much sodium:

      Your Answer: 126 mmol/L

      Correct Answer: 131 mmol/L

      Explanation:

      Hartmann’s solution (compound sodium lactate) contains: Na+131 mmol/L, K+5 mmol/L, HCO3-29 mmol/L (as lactate), Cl-111 mmol/L, Ca2+2 mmol/L. It can be used instead of isotonic sodium chloride solution during or after surgery, or in the initial management of the injured or wounded; it may reduce the risk of hyperchloraemic acidosis.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      9.7
      Seconds
  • Question 8 - A 7-year old boy is referred to the Paediatrics Department due to slurred...

    Correct

    • A 7-year old boy is referred to the Paediatrics Department due to slurred speech. Upon further examination, the attending physician noted the presence of dysdiadochokinesia, intention tremors, and nystagmus. An MRI is taken, which revealed a brain tumour.Which of the following options is the most probable diagnosis given the clinical features of the patient?

      Your Answer: Astrocytoma of cerebellum

      Explanation:

      Pilocytic astrocytoma (PCA), previously known as cystic cerebellar astrocytoma or juvenile pilocytic astrocytoma, was first described in 1931 by Harvey Cushing, based on a case series of cerebellar astrocytomas; though he never used these terms but rather described a spongioblastoma. They are low-grade, and usually well-circumscribed tumours, which tend to occur in young patients. By the World Health Organization (WHO) classification of central nervous system tumours, they are considered grade I gliomas and have a good prognosis.PCA most commonly occurs in the cerebellum but can also occur in the optic pathway, hypothalamus, and brainstem. They can also occur in the cerebral hemispheres, although this tends to be the case in young adults. Presentation and treatment vary for PCA in other locations. Glial cells include astrocytes, oligodendrocytes, ependymal cells, and microglia. Astrocytic tumours arise from astrocytes and are the most common tumour of glial origin. The WHO 2016 categorized these tumours as either diffuse gliomas or other astrocytic tumours. Diffuse gliomas include grade II and III diffuse astrocytomas, grade IV glioblastoma, and diffuse gliomas of childhood. The other astrocytic tumours group include PCA, pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, and anaplastic pleomorphic xanthoastrocytoma.PCA can present with symptoms secondary to the posterior fossa mass effect. This may include obstructive hydrocephalus, with resultant headache, nausea and vomiting, and papilledema. If hydrocephalus occurs before the fusion of the cranial sutures (<18-months-of-age), then an increase in head circumference will likely occur. Lesions of the cerebellar hemisphere result in peripheral ataxia, dysmetria, intention tremor, nystagmus, and dysarthria. In contrast, lesions of the vermis cause a broad-based gait, truncal ataxia, and titubation. Posterior fossa lesions can also cause cranial nerve palsies. Diplopia may occur due to abducens palsy from the stretching of the nerve. They may also have blurred vision due to papilledema. Seizures are rare with posterior fossa lesions.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      20.6
      Seconds
  • Question 9 - The renin-angiotensin-aldosterone system (RAAS) controls blood pressure and fluid balance.Which of the following...

    Incorrect

    • The renin-angiotensin-aldosterone system (RAAS) controls blood pressure and fluid balance.Which of the following sites produces the most angiotensinogen? 

      Your Answer: The kidneys

      Correct Answer: The liver

      Explanation:

      Angiotensinogen is an alpha-2-globulin generated predominantly by the liver and released into the blood. Renin, which cleaves the peptide link between the leucine and valine residues on angiotensinogen, converts it to angiotensin I.Angiotensinogen levels in the blood are raised by:Corticosteroid levels have risen.Thyroid hormone levels have risen.Oestrogen levels have risen.Angiotensin II levels have risen.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      36.1
      Seconds
  • Question 10 - Antidiuretic hormone (ADH) is synthesised by which of the following: ...

    Incorrect

    • Antidiuretic hormone (ADH) is synthesised by which of the following:

      Your Answer: Anterior pituitary

      Correct Answer: Hypothalamus

      Explanation:

      Antidiuretic hormone is synthesised in the hypothalamus and transported to the posterior pituitary within nerve fibres where it is stored in secretory granules. ADH binds V2 receptors on renal principal cells in the late distal tubule and collecting ducts, raising cAMP levels and causing intracellular vesicles to fuse with the apical membrane. In their membrane these vesicles have water channels called aquaporins, which increase the water permeability allowing greater water reabsorption and concentration of urine. Excess levels of ADH results in syndrome of inappropriate ADH secretion (SIADH) characterised by hyponatremia with concomitant hypo-osmolality and high urine osmolality.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      33
      Seconds
  • Question 11 - A GP is considering prescribing a non-steroidal anti-inflammatory (NSAID) for pain relief for...

    Incorrect

    • A GP is considering prescribing a non-steroidal anti-inflammatory (NSAID) for pain relief for a patient with a knee injuryWhich of these statements about NSAIDs is NOT true?

      Your Answer: Use in the 3rd trimester of pregnancy is associated with a risk of foetal kernicterus

      Correct Answer: Side effects are less commonly seen with indomethacin than naproxen

      Explanation:

      Most NSAIDs act as non-selective inhibitors of the enzyme cyclo-oxygenase (COX). They inhibit both COX-1 and COX-2 isoenzymes. Only about 60% of patients will respond to any given NSAID.It can take 21 days of treatment for a clinically appreciable reduction in inflammation to be apparent. If no improvement is seen after 21 days, the NSAID should be changed.The use of NSAIDs in the 3rd trimester of pregnancy is associated with the following risks: delayed onset of labour, premature closure of ductus arteriosus and foetal kernicterus.Side effects are lowest in Ibuprofen and highest in indomethacin. so side effects are more commonly seen with indomethacin than naproxen.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      59.5
      Seconds
  • Question 12 - Cystic fibrosis patients have a weakened lung surfactant system. Which of the following...

    Correct

    • Cystic fibrosis patients have a weakened lung surfactant system. Which of the following cell types is in charge of surfactant secretion?

      Your Answer: Type II pneumocytes

      Explanation:

      Alveolar type II cells are responsible for four primary functions: surfactant synthesis and secretion, xenobiotic metabolism, water transepithelial transport, and alveolar epithelium regeneration following lung injury.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      18.2
      Seconds
  • Question 13 - Regarding gas gangrene, which of the following statements is CORRECT: ...

    Correct

    • Regarding gas gangrene, which of the following statements is CORRECT:

      Your Answer: Infection is characterised by rapidly spreading tissue myonecrosis with crepitus.

      Explanation:

      Gas gangrene usually occurs within 3 days of injury, and is characterised by pain, rapidly spreading oedema, myositis, necrosis, palpable crepitus and systemic toxicity. Diagnosis is clinical and laboratory confirmation should not delay urgent surgical intervention. Hyperbaric oxygen therapy can be considered in addition to surgery and antibiotic therapy, to stop toxin production and inhibit bacteria from replicating and spreading (as Clostridium spp. are obligate anaerobes).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      28.1
      Seconds
  • Question 14 - A patient presents with an adducted eye at rest which cannot abduct past...

    Correct

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

      Your Answer: Abducens nerve

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      49.7
      Seconds
  • Question 15 - A newborn baby is referred by the community midwife who is concerned the...

    Incorrect

    • A newborn baby is referred by the community midwife who is concerned the baby is jaundiced because of the yellow appearance of his eyes and skin following a postnatal home visit. The jaundice is visible in the baby’s feet making her worried.Jaundice are visible in the extremities of neonates at what approximate threshold bilirubin level?

      Your Answer: 100 μmol/L

      Correct Answer: 255 μmol/L

      Explanation:

      Newborn babies have a higher concentration of red blood cells with shorter lifespan leading to higher bilirubin levels than in adults. This condition is short-lived and harmless but with potential serious causes that need to be assessed for if present. The most obvious physical sign of jaundice is a yellow discolouration of the sclera, skin and mucous membranes. At a bilirubin level of 35 μmol/L or higher, the eye is affected. The bilirubin level will need to be higher than 255 μmol/L for the feet and extremities to be affected.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      17.1
      Seconds
  • Question 16 - What is the average healing time for a femoral shaft fracture under normal...

    Correct

    • What is the average healing time for a femoral shaft fracture under normal circumstances? Choose ONE answer.

      Your Answer: 12 weeks

      Explanation:

      The process of fracture healing occurs naturally after traumatic bone disruption and begins with haemorrhage, then progresses through Inflammatory, reparative, and remodelling stagesAverage healing times of common fractures are:Femoral shaft: 12 weeksTibia: 10 weeksPhalanges: 3 weeksMetacarpals: 4-6 weeksDistal radius: 4-6 weeksHumerus: 6-8 weeks

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      33.4
      Seconds
  • Question 17 - The least likely feature expected to be seen in a lesion of the...

    Correct

    • The least likely feature expected to be seen in a lesion of the frontal lobe is which of the following?

      Your Answer: Loss of two-point discrimination

      Explanation:

      Lesions in different areas give rise to different symptoms. Lesions of the parietal lobe give rise to loss of two-point discrimination. Lesions to Broca’s area give rise to expressive dysphasia results from damage Lesions to the primary motor cortex give rise to contralateral weakness of the face and arm. Lesions to the prefrontal cortex give rise to personality change. Lesions to the frontal eye field give rise to conjugate eye deviation towards side of lesion.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      57.1
      Seconds
  • Question 18 - Regarding benzodiazepines, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding benzodiazepines, which of the following statements is INCORRECT:

      Your Answer: Flumazenil is used to antagonise the effects of benzodiazepines.

      Correct Answer: Diazepam is a short-acting benzodiazepine.

      Explanation:

      Diazepam is used to produce mild sedation with amnesia. It is a long-acting drug with active metabolites and a second period of drowsiness can occur several hours after its administration. Midazolam is a water-soluble benzodiazepine that is often used in preference to intravenous diazepam; recovery is faster than from diazepam, but may be significantly longer in the elderly, in patients with a low cardiac output, or after repeated dosing. Midazolam is associated with profound sedation when high doses are given intravenously or when it is used with certain other drugs.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      21.2
      Seconds
  • Question 19 - Which of the following factors decreases insulin secretion: ...

    Incorrect

    • Which of the following factors decreases insulin secretion:

      Your Answer: Acetylcholine

      Correct Answer: Catecholamines

      Explanation:

      Factors that increase insulin secretion:↑ Blood glucose↑ Amino acids↑ Fatty acidsGlucagonSecretinAcetylcholineFactors that decrease insulin secretion:↓ Blood glucoseSomatostatinCatecholamines

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      23.4
      Seconds
  • Question 20 - You see a 30-year-old man who has come to the department with a...

    Correct

    • You see a 30-year-old man who has come to the department with a very tender right elbow. On examination, the elbow is very hot and red, and appears to be acutely inflamed.Which SINGLE statement regarding acute inflammation is FALSE?

      Your Answer: Reduced extravascular osmotic pressure leads to oedema

      Explanation:

      Inflammation can be divided intoacute inflammation, which occurs over seconds, minutes, hours, and days, andchronic inflammation, which occurs over longer periods.Acute inflammationcommences within seconds or minutes following the injury of tissues. There are numerous potential stimuli for an acute inflammatory response including infections (bacterial, viral, fungal, parasitic), tissue necrosis, foreign bodies, and Immune reactions (hypersensitivity reactions). The chief cell type of acute inflammation is the neutrophil.There are three main processesthat occur in the acute inflammatory response:Increased blood flowIncreased capillary permeabilityNeutrophil migration1. Increased blood flow:Vasoactive mediators are released, such as nitric oxide, histamine, bradykinins, and prostaglandin E2. These mediators cause vasodilatation and increased blood flow to the area (causing redness and heat).2. Increased capillary permeability:The vasoactive mediators also cause increased capillary permeability by causing endothelial cell contraction that widens the intercellular gaps of venules. This allows an outpouring of protein-rich fluid (exudate) into the extracellular tissues that results in a reduction of intravascular osmotic pressure and an increase in extravascular/interstitial pressure. The increased interstitial osmotic pressure leads to oedema.3. Neutrophil migration:Neutrophils leave the vasculature through the following sequence of events:Margination and rolling: neutrophils flow nearer the vessel wall, rather than in the axial stream, which is referred to as margination. Following margination the neutrophils begin rolling along the surface of the vascular endothelium.Activation and adhesion: then as a result of interaction with endothelial cell adhesion molecules (CAMs) that is mediated by selectins, the neutrophils are activated and adhere to the endothelium.Transmigration: once bound to the endothelium, neutrophils squeeze through gaps between adjacent endothelial cells into the interstitial fluid, in a process calleddiapedesis.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      54
      Seconds
  • Question 21 - Which of the following is NOT an indication for a H1 receptor antihistamine:...

    Incorrect

    • Which of the following is NOT an indication for a H1 receptor antihistamine:

      Your Answer: Anaphylaxis

      Correct Answer: Gastroesophageal reflux disease

      Explanation:

      Antihistamines are competitive inhibitors at the H1-receptor (in contrast to H2 receptor antagonists used to decrease gastric acid secretion in gastroesophageal reflux disease).Indications: Allergic rhinitis and conjunctivitisUrticarial rashes, pruritus, insect bites and stingsAngioedemaAnaphylaxis (second line adjunct to adrenaline)Nausea/vomiting and prevention of motion sicknessInsomnia

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      11.8
      Seconds
  • Question 22 - A patient presents with a rash for a dermatological examination. A flat circumscribed...

    Correct

    • A patient presents with a rash for a dermatological examination. A flat circumscribed area of discoloured skin measuring 0.7 cm in diameter is seen on examination.What is the best description of this rash that you have found on examination?

      Your Answer: Macule

      Explanation:

      A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin. A vesicle is a visible collection of clear fluid measuring less than 0.5 cm in diameter.A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter. A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless.A plaque is a palpable skin lesion that is elevated and measures >1cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      28.8
      Seconds
  • Question 23 - Regarding conduction of nerve impulses, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding conduction of nerve impulses, which of the following statements is CORRECT:

      Your Answer: The nodes of Ranvier are areas of the axon with a thicker myelin sheath.

      Correct Answer: The action potential in myelinated axons is propagated only at the nodes of Ranvier.

      Explanation:

      An action potential is a self-propagating response, successive depolarisation moving along each segment of an unmyelinated nerve until it reaches the end. It is all-or-nothing and does not decrease in size. Conduction in myelinated fibres is much faster, up to 50 times that of the fastest unmyelinated nerve. Myelinated fibres are insulated except at areas devoid of myelin called nodes of Ranvier. The depolarisation jumps from one node of Ranvier to another by a process called saltatory conduction. Saltatory conduction not only increases the velocity of impulse transmission but also conserves energy for the axon because depolarisation only occurs at the nodes and not along the whole length of the nerve fibre. Larger diameter myelinated nerve fibres conduct nerve impulses faster than small unmyelinated nerve fibres.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      54.2
      Seconds
  • Question 24 - Regarding antimuscarinic antispasmodics, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding antimuscarinic antispasmodics, which of the following statements is CORRECT:

      Your Answer: Antimuscarinics should be used with caution in patients with asthma due to thickening of bronchial secretions.

      Correct Answer: They are contraindicated in paralytic ileus.

      Explanation:

      Antimuscarinics are contraindicated in paralytic ileus. Antimuscarinics reduce intestinal motility by blocking muscarinic acetylcholine receptors and relaxing smooth muscle. Hyoscine butylbromide is advocated as a gastrointestinal antispasmodic, but it is poorly absorbed and thus has limited clinical utility. Antimuscarinics cause a reduction in bronchial secretions (they can be used to this effect in palliative patients). Antispasmodics are occasionally of value in treating abdominal cramp associated with diarrhoea but they should not be used for primary treatment. Antispasmodics should be avoided in young children with gastroenteritis because they are rarely effective and have troublesome side effects.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      52.2
      Seconds
  • Question 25 - A 14-year-old female is brought to the Emergency Room by her mother after...

    Correct

    • A 14-year-old female is brought to the Emergency Room by her mother after a fall from a tree in which she injured her elbow. An elbow fracture is suspected based on the examination findings, and she is given Entonox for analgesia as her elbow is set in a cast. Which one of the following statements regarding this drug is true?

      Your Answer: It can cause inhibition of vitamin B12 synthesis

      Explanation:

      Entonox is a mixture of 50% Oxygen and 50% nitrous oxide and is given in an inhaled form as a quick form of analgesia. Entonox causes non-competitive inhibition of NMDA (N-methyl-D-aspartate) receptors, which are a subtype of the glutamate receptor. It is stored in blue and white cylinders and administered via a pressure regulator and demand valve. The administration of this medicine reduces pain and anxiety in paediatric and dental procedures ands during labour. Effects are apparent after 20 seconds, and peak action occurs after 3 to 5 minutes as it is a drug with a rapid onset and the patient will also recover rapidly from its effects. Entonox is widely used as it does not accumulate in the body and does not cause many side effects. However, a notable side effect is the inhibition of Vitamin B12 synthesis.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      16.3
      Seconds
  • Question 26 - Which of the following statements is true about anterior cord syndrome? ...

    Correct

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

      Your Answer: There is preservation of proprioception

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      39.3
      Seconds
  • Question 27 - You are asked to review the blood results on a 56-year-old man who...

    Incorrect

    • You are asked to review the blood results on a 56-year-old man who appears to be acutely unwell. His results show that he is neutropenic.Which ONE of the following is NOT a recognized cause of a neutropenia?

      Your Answer: Rheumatoid arthritis

      Correct Answer: Hyposplenism

      Explanation:

      Neutropenia is defined as a total neutrophil count of < 2.0 x 109/l.It can be caused by:Viral infectionsCollagen disease e.g. SLE and RAChemotherapy and radiotherapyHypersplenismMarrow infiltrationVitamin and folate deficiencyDrug reactionsDrugs that cause neutropenia include flecainide, phenytoin, carbimazole, indomethacin and co-trimoxazole.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      30.6
      Seconds
  • Question 28 - A 58-year-old patient presents with sputum production and worsening exertional breathlessness. A spirometry...

    Incorrect

    • A 58-year-old patient presents with sputum production and worsening exertional breathlessness. A spirometry is done and his results leads to a diagnosis of obstructive lung disease with mild airflow obstruction.What FEV1 value would correspond with mild airflow obstruction according to the NICE guidelines?

      Your Answer: FEV 1 50-79%

      Correct Answer: FEV 1 >80%

      Explanation:

      Airflow obstruction according to the latest NICE guidelines, is defined as: Mild airflow obstruction = an FEV 1 of >80% in the presence of symptoms Moderate airflow obstruction = FEV 1 of 50-79% Severe airflow obstruction = FEV 1 of 30-49% Very severe airflow obstruction = FEV1<30%.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      19.9
      Seconds
  • Question 29 - You examine a 73-year-old patient who is experiencing a worsening of his chronic...

    Incorrect

    • You examine a 73-year-old patient who is experiencing a worsening of his chronic heart failure. Bumetanide was recently prescribed for him.Which of the following statements about bumetanide is correct?

      Your Answer: It acts on the Na.Cl co-transporter in the distal convoluted tubule to inhibit sodium and chloride reabsorption

      Correct Answer: It has better intestinal absorption than furosemide

      Explanation:

      Bumetanide is a loop diuretic that inhibits sodium, chloride, and potassium reabsorption by acting on the Na.K.2Cl co-transporter in the ascending loop of Henlé. This reduces the osmotic gradient that forces water out of the collecting duct system and prevents the formation of a hypertonic renal medulla. This has a strong diuretic effect on the body.It’s primarily used in patients with heart failure who aren’t responding to high doses of furosemide. Bumetanide and furosemide differ primarily in terms of bioavailability and pharmacodynamic potency.In the intestine, furosemide is only partially absorbed, with a bioavailability of 40-50 percent. Bumetanide, on the other hand, is almost completely absorbed in the intestine and has a bioavailability of about 80%. Bumetanide is 40 times more potent than furosemide, and one milligram is roughly equivalent to 40 milligrams of furosemide.Bumetanide also lowers the concentration of neuronal chloride, making GABA’s action more depolarizing. In the neonatal period, it is being studied as an antiepileptic.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      27.8
      Seconds
  • Question 30 - A 22-year-old student presents with severe headache accompanied with nausea and vomiting. Upon...

    Correct

    • 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: 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
      25
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (2/3) 67%
Specific Pathogen Groups (1/2) 50%
Immune Responses (1/2) 50%
Pathology (4/7) 57%
Anatomy (6/7) 86%
Upper Limb (0/1) 0%
Lower Limb (1/1) 100%
Fluids And Electrolytes (0/1) 0%
Pharmacology (1/7) 14%
Central Nervous System (4/4) 100%
Physiology (1/6) 17%
Renal Physiology (0/1) 0%
Endocrine (0/2) 0%
Musculoskeletal Pharmacology (0/1) 0%
Respiratory (1/2) 50%
Pathogens (1/1) 100%
Cranial Nerve Lesions (1/1) 100%
General Pathology (3/4) 75%
Anaesthesia (1/2) 50%
Basic Cellular (0/1) 0%
Gastrointestinal (0/1) 0%
Haematology (0/1) 0%
Respiratory Physiology (0/1) 0%
Cardiovascular Pharmacology (0/1) 0%
Passmed