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  • Question 1 - Intracellular [Ca2+] rise in cardiac excitation-contraction coupling is mainly as a result of:...

    Incorrect

    • Intracellular [Ca2+] rise in cardiac excitation-contraction coupling is mainly as a result of:

      Your Answer: Ca 2+ influx through Na + /Ca 2+ exchange

      Correct Answer: Ca 2+ release from sarcoplasmic reticulum

      Explanation:

      Although Ca2+entry during the action potential (AP) is essential for contraction, it only accounts for about 25% of the rise in intracellular Ca2+. The rest is released from Ca2+stores in the sarcoplasmic reticulum (SR). APs travel down invaginations of the sarcolemma called T-tubules, which are close to, but do not touch, the terminal cisternae of the SR. During the AP plateau, Ca2+enters the cell and activates Ca2+sensitive Ca2+release channels in the sarcoplasmic reticulum allowing stored Ca2+to flood into the cytosol; this is called Ca2+-induced Ca2+release. The amount of Ca2+released is dependent on how much is stored, and on the size of the initial Ca2+influx during the AP.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      39
      Seconds
  • Question 2 - Osteoclasts are a type of bone cell that are critical in the maintenance,...

    Incorrect

    • Osteoclasts are a type of bone cell that are critical in the maintenance, repair and remodelling of bones.Which of the following inhibits osteoclast activity? Select ONE answer only.

      Your Answer: Thyroxine

      Correct Answer: Calcitonin

      Explanation:

      Osteoclasts are a type of bone cell that breaks down bone tissue. This is a critical function in the maintenance, repair and remodelling of bones. The osteoclast disassembles and digests the composite of hydrated protein and minerals at a molecular level by secreting acid and collagenase. This process is known as bone resorption and also helps to regulate the plasma calcium concentration.Osteoclastic activity is controlled by a number of hormones:1,25-dihydroxycholecalciferol increases osteoclastic activityParathyroid hormone increases osteoclastic activityCalcitonin inhibits osteoclastic activityBisphosphonates are a class of drug that slow down and prevent bone damage. They are osteoclast inhibitors.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      101.8
      Seconds
  • Question 3 - Regarding the intervertebral disc, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the intervertebral disc, which of the following statements is CORRECT:

      Your Answer: Herniation of the intervertebral disc occurs when the outer fibrous layer herniates through vertebral bodies.

      Correct Answer: In L4 - L5 disc herniation, the L5 spinal nerve root is the most commonly affected.

      Explanation:

      A posterolateral herniation of the disc at the L4 – L5 level would be most likely to damage the fifth lumbar nerve root, not the fourth lumbar nerve root, due to more oblique descending of the fifth lumbar nerve root within the subarachnoid space.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      76.6
      Seconds
  • Question 4 - A 60-year-old female has a past medical history of diverticular disease. She now...

    Correct

    • A 60-year-old female has a past medical history of diverticular disease. She now presents in the clinic with crampy abdominal pain. The nurse at the triage suggests prescribing hyoscine butyl bromide to help relieve the abdominal pain. However, after administering this treatment, the patient develops a side-effect to the medication. What side-effect of using hyoscine butyl bromide is she MOST likely to develop out of the following?

      Your Answer: Dry mouth

      Explanation:

      Hyoscine butylbromide is an antispasmodic drug that blocks muscarinic receptors and reduces intestinal motility. It is used for gastrointestinal and genitourinary smooth muscle spasms and symptomatic relief of IBS.It has the following side-effects:1. Constipation2. Dizziness3. Drowsiness4. Dry mouth5. Dyspepsia6. Flushing7. Headache8. Nausea and vomiting9. Palpitations10. Skin reactions11. Tachycardia12. Urinary disorders13. Disorders of vision

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      88.3
      Seconds
  • Question 5 - Regarding penicillin antibiotics, which of the following statements is CORRECT: ...

    Correct

    • Regarding penicillin antibiotics, which of the following statements is CORRECT:

      Your Answer: Patients with a history of atopy are at higher risk of hypersensitivity reactions.

      Explanation:

      Allergic reactions to penicillins occur in 1 – 10% of exposed individuals; anaphylactic reactions occur in fewer than 0.05% of treated patients. Patients with a history of atopic allergy are at higher risk of anaphylactic reactions to penicillins. Patients with a history of anaphylaxis, urticaria, or rash immediately after penicillin use should not receive a penicillin or other beta-lactam antibiotics; about 0.5 – 6.5 % of penicillin-sensitive patients will also be allergic to the cephalosporins. Patients with a history of a more minor rash (i.e. non-confluent, non-pruritic rash restricted to a small area of the body) or delayed reaction (rash occurring more than 72 hours after penicillin administration), may not be truly allergic and may be considered for penicillin or beta-lactam treatment in severe infection (although possibility of allergy should be borne in mind). Other beta-lactam antibiotics (including cephalosporins) can be used in these patients.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      119.5
      Seconds
  • Question 6 - Which statement regarding skeletal muscle is true? ...

    Incorrect

    • Which statement regarding skeletal muscle is true?

      Your Answer: Actin is the major constituent of the thick filament

      Correct Answer: Myosin is the major constituent of the thick filament

      Explanation:

      Myosin is the major constituent of the thick filament. Actin is the major constituent of the THIN filament. Thin filaments consist of actin, tropomyosin and troponin in the ratio 7:1:1.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      73.9
      Seconds
  • Question 7 - The fracture of the medial epicondyle will cause damage to the ulnar nerve....

    Incorrect

    • The fracture of the medial epicondyle will cause damage to the ulnar nerve. Which of the following motions would be impaired by this type of injury?

      Your Answer: Opposition of the thumb

      Correct Answer: Adduction of the thumb

      Explanation:

      Fracture of the medial epicondyle is most likely to result in damage to the ulnar nerve. The three hypothenar muscles, two medial lumbricals, seven interossei, the adductor pollicis, and the deep head of the flexor pollicis brevis are all innervated by the deep branch of the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      82.1
      Seconds
  • Question 8 - A 32-year-old woman presents with abdominal pain and bloody diarrhoea that has been...

    Incorrect

    • A 32-year-old woman presents with abdominal pain and bloody diarrhoea that has been going on for 3 days.Among the following microorganisms, which is considered to be a cause of infectious bloody diarrhoea?

      Your Answer: Giardia lamblia

      Correct Answer: Entamoeba histolytica

      Explanation:

      The following are organisms that are capable of producing acute, bloody diarrhoea:- Campylobacter jejuni- Escherichia coli O157:H7- Salmonella species- Shigella species- Yersinia species- Entamoeba histolyticaOther E. coli strains, Giardia, Vibrio, and other parasites are associated with watery, but not bloody, diarrhoea.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      236.6
      Seconds
  • Question 9 - Most of the lymph from vessels that drain the breast is collected in...

    Correct

    • Most of the lymph from vessels that drain the breast is collected in which of the following lymph nodes?

      Your Answer: Axillary nodes

      Explanation:

      Lymph is the fluid that flows through the lymphatic system. Axillary lymph nodes are near the breasts. They are often the first location to which breast cancer spreads if it moves beyond the breast tissue. They receive approximately 75% of lymph drainage from the breast via lymphatic vessels, laterally and superiorly. The lymph usually first drains to the anterior axillary nodes, and from here, through the central axillary, apical, and supraclavicular nodes in sequence.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      10.3
      Seconds
  • Question 10 - A patient suffers a stab wound to the neck. The entry point of...

    Incorrect

    • A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck.Which of the following muscles is most likely to be involved? Select ONE answer only.

      Your Answer: Trapezius

      Correct Answer: Anterior scalene

      Explanation:

      The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains:Muscles: thyrohyoid, sternothyroid, sternohyoid musclesOrgans: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid glandArteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteriesVeins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veinsNerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerveThe posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle.Contents:Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodesNerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexusOf the muscles listed in the options, only the anterior scalene is situated within the posterior triangle of the neck.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      74.4
      Seconds
  • Question 11 - The parasympathetic supply to the rectum is from which of the following: ...

    Incorrect

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

      Your Answer: Sacral splanchnic nerves

      Correct Answer: Pelvic splanchnic nerves

      Explanation:

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      45.4
      Seconds
  • Question 12 - 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
      58.5
      Seconds
  • Question 13 - A 21-year-old student presents with fever, headache, malaise, fatigue, and muscle aches after...

    Incorrect

    • A 21-year-old student presents with fever, headache, malaise, fatigue, and muscle aches after returning from a trip to India. A diagnosis of malaria was suspected.Which of the following statements is considered correct regarding malaria?

      Your Answer: Plasmodium vivax is usually treated with Quinine

      Correct Answer: Haemoglobinuria and renal failure following treatment is suggestive of Plasmodium falciparum

      Explanation:

      Malaria results from infection with single-celled parasites belonging to the Plasmodium genus. Five species of Plasmodium are known to cause disease in humans: P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi. Chloroquine remains the mainstay of treatment for uncomplicated vivax malaria.The female Anopheles mosquito serves as the biologic vector and definitive host. A complication of infection with P. falciparum is blackwater fever, a condition characterized by haemoglobinuria. Plasmodium ovale has the longest incubation period, which can be up to 40 days. Plasmodium falciparum has a shorter incubation period of 7-14 days.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      57.7
      Seconds
  • Question 14 - Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or...

    Incorrect

    • Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or rectosigmoid should be treated initially with:

      Your Answer: Oral steroid

      Correct Answer: Local aminosalicylate

      Explanation:

      Acute mild to moderate disease affecting the rectum (proctitis) or the rectosigmoid is treated initially with local application of an aminosalicylate; alternatively, a local corticosteroid can be used but it is less effective. A combination of a local aminosalicylate and a local corticosteroid can be used for proctitis that does not respond to a local aminosalicylate alone.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      60
      Seconds
  • Question 15 - A 18 year old student presents to ED with a headache, fever and...

    Incorrect

    • A 18 year old student presents to ED with a headache, fever and photophobia. You suspect meningitis and agree to observe your junior performing a lumbar puncture. What is the highest safest vertebral level to perform lumbar puncture in adults:

      Your Answer: L2/L3

      Correct Answer: L3/L4

      Explanation:

      In adults, the spinal cord typically ends between L1/L2 whereas the subarachnoid space extends to approximately the lower border of vertebra S2. Lumbar puncture is performed in the intervertebral space L4/L5 or L3/L4.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      61.4
      Seconds
  • Question 16 - By the third day of wound healing, which sort of inflammatory cell has...

    Correct

    • By the third day of wound healing, which sort of inflammatory cell has predominated:

      Your Answer: Macrophages

      Explanation:

      The inflammatory phase of healing is sometimes called the lag phase because wound strength does not begin to return immediately. The inflammatory phase is completed within three days except in the presence of infection or other factors associated with impaired wound healing. Mononuclear leukocytes accumulate and are transformed into macrophages. The maturation of blood-derived monocytes into macrophages is heralded by several events, including secretion of vimentin, which is a structural filament protein involved in wound healing.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      10.4
      Seconds
  • Question 17 - Which of the following is NOT an adverse effect associated with warfarin therapy:...

    Correct

    • Which of the following is NOT an adverse effect associated with warfarin therapy:

      Your Answer: Neutropenia

      Explanation:

      Adverse effects of warfarin:The most common adverse effect of warfarin is bleedingOther common adverse effects of warfarin include nausea, vomiting, diarrhoea, jaundice, hepatic dysfunction, pancreatitis, pyrexia, alopecia, purpura, and rashSkin necrosis is a rare but serious adverse effect of warfarin; treatment with warfarin should be stopped if warfarin related skin necrosis is suspectedCalciphylaxis is a rare, but a very serious condition that causes vascular calcification and cutaneous necrosis

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      36.2
      Seconds
  • Question 18 - Typically, granulomatous inflammation is associated with one of the following infections: ...

    Correct

    • Typically, granulomatous inflammation is associated with one of the following infections:

      Your Answer: Tuberculosis

      Explanation:

      Granulomatous inflammation is typically seen when an infective agent with a digestion-resistance capsule (e.g. Mycobacterium tuberculosis) or a piece of inert foreign material (such as suture or glass) is introduced into the tissue. A transient acute inflammatory response occurs and when this is ineffective in eradicating the stimulus, chronic inflammation occurs.Tuberculosis is the prototype of the granulomatous diseases, but sarcoidosis, cat-scratch disease, lymphogranuloma inguinale, leprosy, brucellosis, syphilis, some mycotic infections, berylliosis, reactions of irritant lipids, and some autoimmune diseases are also included

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      14.7
      Seconds
  • Question 19 - The renal team is currently prescribing erythropoietin to a patient with chronic kidney...

    Incorrect

    • The renal team is currently prescribing erythropoietin to a patient with chronic kidney disease.Which of the following statements about erythropoietin is correct?

      Your Answer: It increases oxygen affinity

      Correct Answer: It protects red blood cell progenitors from apoptosis

      Explanation:

      Erythropoietin is a glycoprotein hormone that regulates the formation of red blood cells (red cell production). It is mostly produced by interstitial fibroblasts in the kidney, which are located near the PCT. It is also produced in the liver’s perisinusoidal cells, however this is more common during the foetal and perinatal periods.The kidneys produce and secrete erythropoietin in response to hypoxia. On red blood cells, erythropoietin has two main effects:- It encourages stem cells in the bone marrow to produce more red blood cells.- It protects red blood cell progenitors and precursors from apoptosis by targeting them in the bone marrow.As a result of the increased red cell mass, the oxygen-carrying capacity and oxygen delivery increase.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      51.8
      Seconds
  • Question 20 - A patient presents with a rash for dermatological examination. A large area of...

    Incorrect

    • A patient presents with a rash for dermatological examination. A large area of purplish discolouration of the skin that measures 2 cm in diameter and does not blanch when pressure is applied is seen .What is the best description of this rash that you have found on examination?

      Your Answer: Erythema

      Correct Answer: Ecchymoses

      Explanation:

      Ecchymosis are discolouration of the skin or mucous membranes caused by extravasation of blood. They are usually red or purple in colour and measure greater than 1 cm in diameter and do not blanch on applying pressure. 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. Petechiae are discolouration of the skin measuring less than 3 mm in diameterPurpura are discolouration of the skin measuring between 0.3 cm and 1 cm in diameter.Erythema is redness of the skin or mucous membranes caused by hyperaemia of superficial capillaries caused by skin injury, infection or inflammation. Erythema blanches when pressure is applied whereas ecchymosis, purpura and petechiae do not.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      69.7
      Seconds
  • Question 21 - Which of the following statements is correct regarding anti-D immunoglobulin? ...

    Correct

    • Which of the following statements is correct regarding anti-D immunoglobulin?

      Your Answer: It is administered as part of routine antenatal care for rhesus-negative mothers.

      Explanation:

      In all non-sensitised pregnant women who are RhD-negative, it is recommended that routine antenatal anti-D prophylaxis is offered. Even if there is previous anti-D prophylaxis, use of routine antenatal anti-D prophylaxis should be given for a sensitising event early in the same pregnancy. Postpartum anti-D prophylaxis should also be given even if there has been previous routine antenatal anti-D prophylaxis or antenatal anti-D prophylaxis for a sensitising event in the same pregnancy.

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      62.6
      Seconds
  • Question 22 - An arterial blood gas test is performed to a 25-year-old students who presents...

    Incorrect

    • An arterial blood gas test is performed to a 25-year-old students who presents with confusion, headache, nausea and malaise. The results show that carbon monoxide levels are significantly high. Which of the following carbon monoxide poisoning assertions is true?

      Your Answer: It has approximately 25 times the affinity for haemoglobin than oxygen does

      Correct Answer: The PO 2 of the blood in CO poisoning can be normal

      Explanation:

      By combining with haemoglobin to form carboxyhaemoglobin, carbon monoxide (CO) disrupts the blood’s oxygen transport function. CO binds to haemoglobin with a 240-fold higher affinity than oxygen. As a result, even small amounts of CO can bind a large portion of the blood’s haemoglobin, making it unavailable for oxygen transport. During a suspected carbon monoxide poisoning, the blood PO2 and haemoglobin concentrations will be normal, but the oxygen concentration will be drastically reduced. The oxygen dissociation curve will also shift to the left in the presence of Carboxyhaemoglobin ( haemoglobin and carbon monoxide combination), interfering with oxygen unloading.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      106.3
      Seconds
  • Question 23 - A 22-year-old with a history of brittle asthma is brought to the ED...

    Incorrect

    • A 22-year-old with a history of brittle asthma is brought to the ED by her partner. She is wheezing and very short of breath and her condition is deteriorating rapidly. Following a series of nebulisations, hydrocortisone and IV magnesium sulphate, she is taken to resus and the intensive care team is called to review her. She is severely hypoxic and confused and a decision is made to intubate her.Which of these drugs is ideal as an induction agent in this patient?

      Your Answer: Etomidate

      Correct Answer: Ketamine

      Explanation:

      Only about 2% of asthma attacks requires intubation and most severe cases are managed with non-invasive ventilation techniques.Though life-saving in the crashing asthmatic, intubation in asthmatic patients is associated with significant morbidity and mortality and is risky. Indications for intubation in asthmatic patients include:Severe hypoxiaAltered mental stateRespiratory or cardiac arrestFailure to respond to medicationsKetamine (1-2 mg/kg) is the preferred induction agent. It has bronchodilatory properties and does not cause hypotension. Propofol poses a risk of hypotension but can also be used.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      51.6
      Seconds
  • Question 24 - What is the recommended dosing regime for amiodarone in the treatment of a...

    Incorrect

    • What is the recommended dosing regime for amiodarone in the treatment of a stable regular broad-complex tachycardia:

      Your Answer: 300 mg IV over 20 - 60 minutes, followed by further 300 mg IV infusion over 20 - 60 minutes if no response

      Correct Answer: 300 mg IV over 10 - 60 minutes, followed by an IV infusion of 900 mg over the next 24 hours

      Explanation:

      A ventricular tachycardia (or broad-complex tachycardia of uncertain origin) should be treated with amiodarone 300 mg IV over 10 – 60 min, followed by an infusion of 900 mg over the next 24 hours.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      71.3
      Seconds
  • Question 25 - A 23-year-old female has been prescribed a medication in the first trimester of...

    Incorrect

    • A 23-year-old female has been prescribed a medication in the first trimester of pregnancy due to a life-threatening medical problem. After delivery, the foetus is found to have nasal hypoplasia, stippling of his bones and atrophy of bilateral optic discs along with growth retardation. Which ONE of the following drugs has this woman most likely received?

      Your Answer: Lithium

      Correct Answer: Warfarin

      Explanation:

      Warfarin is teratogenic and can cause a host of abnormalities in the growing foetus. These include hypoplasia of the nasal bridge, stippling of the epiphyses, multiple ophthalmic complications, growth retardation, pectus carinatum, atrial septal defect, ventriculomegaly and a patent ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      71.1
      Seconds
  • Question 26 - A 50-year-old woman has an anaphylactic reaction following accidental ingestion peanuts at a...

    Correct

    • A 50-year-old woman has an anaphylactic reaction following accidental ingestion peanuts at a restaurant. She is a known hypertensive on atenolol 50 mg daily and BP is well controlled. She is also on amlodipine 5 mg daily. Two doses of IM adrenaline has been given without improvement.Which medication may prove helpful in this patient?

      Your Answer: IM Glucagon

      Explanation:

      Resistant to the effects of adrenaline in anaphylaxis is seen in patients taking beta-blockers.Glucagon can be used to overcome the effects of the beta-blockade if initial doses of adrenaline are unsuccessful in patients taking beta-blockers.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      82.8
      Seconds
  • Question 27 - Regarding codeine, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer: Codeine is contraindicated in children under 12 years old.

      Correct Answer: There is a reduced risk of toxicity in patients who are ultra-rapid metabolisers of codeine.

      Explanation:

      Codeine phosphate is a weak opioid and can be used for the relief of mild to moderate pain where other painkillers such as paracetamol or ibuprofen have proved ineffective.Codeine is metabolised to morphine which is responsible for its therapeutic effects. Codeine 240 mg is approximately equivalent to 30 mg of morphine. The capacity to metabolise codeine can vary considerably between individuals; there is a marked increase in morphine toxicity in people who are ultra rapid metabolisers, and reduced therapeutic effect in poor codeine metabolisers. Codeine is contraindicated in patients of any age who are known to be ultra-rapid metabolisers of codeine (CYP2D6 ultra-rapid metabolisers).Codeine is also contraindicated in children under 12, and in children of any age who undergo the removal of tonsils or adenoids for the treatment of obstructive sleep apnoea due to reports of morphine toxicity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      43.5
      Seconds
  • Question 28 - Gastrin release from antral G-cells is inhibited by all but which one of...

    Incorrect

    • Gastrin release from antral G-cells is inhibited by all but which one of the following:

      Your Answer: Somatostatin

      Correct Answer: Vagal stimulation

      Explanation:

      Gastrin secretion is inhibited by:Low gastric pH (negative feedback mechanism)SomatostatinSecretinGastric inhibitory polypeptide (GIP)Cholecystokinin

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      53.1
      Seconds
  • Question 29 - All of the following statements are considered true regarding randomized control trials, except:...

    Incorrect

    • All of the following statements are considered true regarding randomized control trials, except:

      Your Answer: They can help to overcome ‘publication bias’

      Correct Answer: They can eliminate the need for further studies

      Explanation:

      Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess previous research studies to derive conclusions about that body of research. Outcomes from a meta-analysis may include a more precise estimate of the effect of treatment or risk factor for disease, or other outcomes, than any individual study contributing to the pooled analysis. The examination of variability or heterogeneity in study results is also a critical outcome.The benefits of meta-analysis include a consolidated and quantitative review of a large, and often complex, sometimes apparently conflicting, body of literature. The specification of the outcome and hypotheses that are tested is critical to the conduct of meta-analyses, as is a sensitive literature search.Important medical questions are typically studied more than once, often by different research teams in different locations. In many instances, the results of these multiple small studies of an issue are diverse and conflicting, which makes the clinical decision-making difficult. The need to arrive at decisions affecting clinical practise fostered the momentum toward evidence-based medicine. Evidence-based medicine may be defined as the systematic, quantitative, preferentially experimental approach to obtaining and using medical information. Therefore, meta-analysis, a statistical procedure that integrates the results of several independent studies, plays a central role in evidence-based medicine.

    • This question is part of the following fields:

      • Evidence Based Medicine
      65.5
      Seconds
  • Question 30 - A clinical audit cycle comprises of 5 steps. Each of these processes are...

    Incorrect

    • A clinical audit cycle comprises of 5 steps. Each of these processes are listed below:Which is the correct order that these should occur?1. Observation of practice and collection of data2. Identification of the problem3. Implementation of change4. Definition of criteria and setting of standards5. Analysis of data and comparison of performance with the criteria and standards

      Your Answer:

      Correct Answer: 2,4,1,5,3

      Explanation:

      An audit assesses if a certain aspect of health care is attaining a recognized standard. This lets care providers and patients know where their service is doing well, and where there could be improvements. The aim is to achieve quality improvement and improve outcomes for patients.Audits are a quality improvement measure and one of the 7 pillars of clinical governance. It allows organizations to continually work toward improving quality of care by showing them where they are falling short, allows them to implement improvements, and reaudit or close the audit cycle to see if beneficial change has taken place.Clinical audits are a cycle with several steps:1. Identification of the problem2. Definition of criteria and setting of standards3. Observation of practice and collection of data4. Analysis of data and comparison of performance with the criteria and standards5. Implementation of change

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (1/3) 33%
Physiology (0/6) 0%
Endocrine Physiology (0/1) 0%
Anatomy (1/6) 17%
Head And Neck (0/3) 0%
Gastrointestinal Pharmacology (1/1) 100%
Pharmacology (5/11) 45%
Infections (1/1) 100%
Basic Cellular Physiology (0/1) 0%
Upper Limb (1/2) 50%
Microbiology (0/2) 0%
Specific Pathogen Groups (0/2) 0%
Abdomen (0/1) 0%
Cardiovascular Pharmacology (0/2) 0%
Gastrointestinal (0/2) 0%
Pathology (2/3) 67%
Wound Healing (1/1) 100%
Inflammatory Responses (1/1) 100%
Renal Physiology (0/1) 0%
General Pathology (0/1) 0%
Immunoglobulins And Vaccines (1/1) 100%
Respiratory Physiology (0/1) 0%
Respiratory Pharmacology (1/2) 50%
Central Nervous System (0/1) 0%
Evidence Based Medicine (0/1) 0%
Passmed