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  • Question 1 - Hepatitis A is transmitted by which of the following routes: ...

    Incorrect

    • Hepatitis A is transmitted by which of the following routes:

      Your Answer: Direct skin contact

      Correct Answer: Faecal-oral route

      Explanation:

      Hepatitis A transmission is by the faecal-oral route; the virus is excreted in bile and shed in the faeces of infected people.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      129.8
      Seconds
  • Question 2 - Intrinsic factor is secreted by which of the following cell types in the...

    Incorrect

    • Intrinsic factor is secreted by which of the following cell types in the stomach:

      Your Answer: Principal cells

      Correct Answer: Parietal cells

      Explanation:

      Intrinsic factor is essential for the absorption of the small amounts of vitamin B12 normally present in the diet from the terminal ileum. The parietal cells of the stomach produce intrinsic factor, and following a gastrectomy, the absorption of vitamin B12 will be markedly reduced, and a deficiency state will exist.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      28.2
      Seconds
  • Question 3 - Regarding inhaled corticosteroids, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding inhaled corticosteroids, which of the following statements is INCORRECT:

      Your Answer: Symptom improvement usually occurs 3 - 7 days after initiation of treatment.

      Correct Answer: Lower doses of inhaled corticosteroids may be required in smokers.

      Explanation:

      Current and previous smoking reduces the effectiveness of inhaled corticosteroids and higher doses may be necessary.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      56.3
      Seconds
  • Question 4 - Which of the following is NOT a notifiable disease: ...

    Incorrect

    • Which of the following is NOT a notifiable disease:

      Your Answer: Food poisoning

      Correct Answer: HIV

      Explanation:

      HIV mainly infects CD4+ T helper cells. Viral replication results in progressive T-cell depletion and impaired cell-mediated immunity with subsequent secondary opportunistic infections and increased risk of malignancy. B-cell function is also reduced as a result of lack of T-cell stimulation.HIV is not a notifiable disease.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      10
      Seconds
  • Question 5 - Mast cells play a significant part in which of the following? ...

    Incorrect

    • Mast cells play a significant part in which of the following?

      Your Answer: Killing virus infected cells

      Correct Answer: Allergic disease

      Explanation:

      Mast cells play a central role in the response to allergen challenges. The activation of mast cells results in both an early and a delayed phase of inflammation. Mast cells have been implicated in both physiologic and pathogenic processes. Mast cells are important in defence against some bacteria and viruses and contribute to defence against parasites. They are key effector cells in both innate and acquired immunity and are capable of inducing and amplifying both types of responses. Specifically, mast cells are capable of detecting microbial products through surface pattern recognition receptors, and they are involved in the recruitment of other leukocytes, containment of bacterial infections, and tissue repair.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      27.3
      Seconds
  • Question 6 - Which of the following globin chains makes up haemoglobin A2 (HbA2)? ...

    Correct

    • Which of the following globin chains makes up haemoglobin A2 (HbA2)?

      Your Answer: Two alpha chains and two delta chains

      Explanation:

      Haemoglobin is a 64.4 kd tetramer consisting of two pairs of globin polypeptide chains: one pair of alpha-like chains, and one pair of non-alpha chains. The chains are designated by Greek letters, which are used to describe the particular haemoglobin (e.g., Hb A is alpha2/beta2).Two copies of the alpha-globin gene (HBA2, HBA1) are located on chromosome 16 along with the embryonic zeta genes (HBZ). There is no substitute for alpha globin in the formation of any of the normal haemoglobins (Hb) following birth (e.g., Hb A, Hb A2, and Hb F). Thus, absence any alpha globin, as seen when all 4 alpha-globin genes are inactive or deleted is incompatible with extrauterine life, except when extraordinary measures are taken. A homotetramer of only alpha-globin chains is not thought to occur, but in the absence of alpha chains, beta and gamma homotetramers (HbH and Bart’s haemoglobin, respectively) can be found, although they lack cooperativity and function poorly in oxygen transport. The single beta-globin gene (HBB) resides on chromosome 11, within a gene cluster consisting of an embryonic beta-like gene, the epsilon gene (HBE1), the duplicated and nearly identical fetal, or gamma globin genes (HBG2, HBG1), and the poorly expressed delta-globin gene (HBD). A heme group, consisting of a single molecule of protoporphyrin IX co-ordinately bound to a single ferrous (Fe2+) ion, is linked covalently at a specific site to each globin chain. If the iron is oxidized to the ferric state (Fe3+), the protein is called methaemoglobin.Alpha globin chains contain 141 amino acids (residues) while the beta-like chains contain 146 amino acids. Approximately 75 percent of haemoglobin is in the form of an alpha helix. The non helical stretches permit folding of the polypeptide upon itself. Individual residues can be assigned to one of eight helices (A-H) or to adjacent non helical stretches.Heme iron is linked covalently to a histidine at the eighth residue of the F helix (His F8), at residue 87 of the alpha chain and residue 92 of the beta chain. Residues that have charged side groups, such as lysine, arginine, and glutamic acid, lie on the surface of the molecule in contact with the surrounding water solvent. Exposure of the hydrophilic (charged) amino acids to the aqueous milieu is an important determinant of the solubility of haemoglobin within the red blood cell and of the prevention of precipitation.The haemoglobin tetramer is a globular molecule (5.0 x 5.4 x 6.4 nm) with a single axis of symmetry. The polypeptide chains are folded such that the four heme groups lie in clefts on the surface of the molecule equidistant from one another.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      39.8
      Seconds
  • Question 7 - A 58-year-old woman presents with symptoms of increase in weight, proximal muscular weakening...

    Correct

    • A 58-year-old woman presents with symptoms of increase in weight, proximal muscular weakening and withering, easy bruising, and acne. You notice that she has a full, plethoric aspect to her face, as well as significant supraclavicular fat pads, when you examine her. She has previously been diagnosed with Cushing's syndrome.Cushing's syndrome is most commonly caused by which of the following?

      Your Answer: Iatrogenic administration of corticosteroids

      Explanation:

      Cushing’s syndrome is a group of symptoms and signs brought on by long-term exposure to high amounts of endogenous or exogenous glucocorticoids. Cushing’s syndrome affects about 10-15 persons per million, and it is more common in those who have had a history of obesity, hypertension, or diabetes.Iatrogenic corticosteroid injection is the most prevalent cause of Cushing’s syndrome. Cushing’s illness is the second most prevalent cause of Cushing’s syndrome. Cushing’s disease is distinct from Cushing’s syndrome in that it refers to a single cause of the illness, a pituitary adenoma that secretes high quantities of ACTH, which raises cortisol levels.Cushing’s syndrome has several endogenous sources, including:Cushing’s disease is caused by a pituitary adenoma.Adrenal adenoma Ectopic corticotropin syndrome, e.g. small cell cancer of the lungAdrenal carcinoma is a cancer of the adrenal gland.Hyperplasia of the adrenal glands

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      61.1
      Seconds
  • Question 8 - Regarding fat digestion, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding fat digestion, which of the following statements is CORRECT:

      Your Answer: Gastric lipase is the most important enzyme in lipid digestion.

      Correct Answer: Chylomicrons are exocytosed from enterocytes to enter lacteals and thus the lymphatic system.

      Explanation:

      Dietary fat is chiefly composed of triglycerides (esters of free fatty acids and glycerol which may be saturated or unsaturated). The essential fatty acids are linoleic acid and alpha-linoleic acid, which cannot be manufactured in the body. Dietary fat provides 37 kJ (9 kcal) of energy per gram. Fats are digested almost entirely in the small intestine and are only released from the stomach into the duodenum at the rate at which they can be digested.Pancreatic lipase is the most significant enzyme for fat digestion. In the duodenum fat is emulsified by bile acids, a process where larger lipid droplets are broken down into much smaller droplets providing a greater surface area for enzymatic digestion. Micelles are arranged so that hydrophobic lipid molecules lie in the centre, surrounded by bile acids arranged such the outer region is hydrophilic. Dietary and synthesised lipids are incorporated into chylomicrons in the Golgi body, which are exocytosed from the basolateral membrane to enter lacteals and thus the lymphatic system.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      31.3
      Seconds
  • Question 9 - Which of the following immunoglobulin molecules is the most abundant in secretions (such...

    Incorrect

    • Which of the following immunoglobulin molecules is the most abundant in secretions (such as saliva and breast milk):

      Your Answer: IgE

      Correct Answer: IgA

      Explanation:

      IgA is the predominant antibody class in secretions and tremendous quantities are secreted into various body spaces and onto mucosal surfaces (the gut lumen, the pharynx and sinuses, the larger airways, although not the alveoli). Because of its size, the majority of IgM is found in the circulation.Along with IgM, IgD is predominant among the surface receptors of mature B cells, where it plays a key role in B cells activation.IgE has the lowest concentration in normal human serum. It plays a prominent role in immune responses to helminth parasites, and in allergic reactions.IgG is the most abundant immunoglobulin and constitutes 75 percent of serum immunoglobulin in an adult human

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      10.5
      Seconds
  • Question 10 - Nitrous oxide is associated with which of the following adverse effects: ...

    Incorrect

    • Nitrous oxide is associated with which of the following adverse effects:

      Your Answer: Laryngospasm

      Correct Answer: Megaloblastic anaemia

      Explanation:

      Exposure to nitrous oxide for prolonged periods, either by continuous or by intermittent administration, may result in megaloblastic anaemia as a result of interference with the action of vitamin B12; neurological toxic effects can occur without preceding overt haematological changes. Depression of white cell formation may also occur.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      16.8
      Seconds
  • Question 11 - Regarding the lacrimal apparatus, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the lacrimal apparatus, which of the following statements is CORRECT:

      Your Answer: The lacrimal sac empties via lacrimal canaliculi.

      Correct Answer: Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

      Explanation:

      Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      79.9
      Seconds
  • Question 12 - Regarding codeine, which of the following statements is INCORRECT: ...

    Correct

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

      Your 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
      63.6
      Seconds
  • Question 13 - A 30-year-old woman was involved in a road traffic accident and had a...

    Incorrect

    • A 30-year-old woman was involved in a road traffic accident and had a class I haemorrhage.Which physiological parameter is consistent with a diagnosis of class I haemorrhage?

      Your Answer: 25% of blood volume lost

      Correct Answer: Increased pulse pressure

      Explanation:

      There are 4 classes of haemorrhage. Classification is based on clinical signs and physiological parameters.In CLASS I:Blood loss (ml) is < or = 750Blood loss(% blood volume) < or = 15%Pulse rate (bpm) is 30Pulse pressure is normal or increasedSystolic BP is normalCNS/mental status patient is slightly anxious In CLASS II:Blood loss (ml) is 750 – 1500Blood loss(% blood volume) is 15 – 30%Pulse rate (bpm) is 100 – 120Respiratory rate is 20-30Urine output (ml/hr) is 20-30Pulse pressure is decreasedSystolic BP is normalCNS/mental status patient is mildly anxiousIn CLASS III:Blood loss (ml) is 1500 – 2000Blood loss(% blood volume) is 30- 40%Pulse rate (bpm) is 120 – 140Respiratory rate is 30-40Urine output (ml/hr) is 5-15Pulse pressure is decreasedSystolic BP is decreasedCNS/mental status patient is anxious, confusedIn CLASS IV:Blood loss (ml) is >2000Blood loss(% blood volume) is >40%Pulse rate (bpm) is >140Respiratory rate is >40Urine output (ml/hr) is negligiblePulse pressure is decreasedSystolic BP is decreasedCNS/mental status patient is confused, lethargic

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      45.1
      Seconds
  • Question 14 - A new blood test is being developed to diagnose DVT. 1000 people presenting...

    Incorrect

    • A new blood test is being developed to diagnose DVT. 1000 people presenting to ED with suspected DVT undergo the new blood test and the gold standard doppler ultrasound to confirm the diagnosis. Of the 1000 people, 77 are confirmed to have a DVT. Of the patients diagnosed with DVT, 75 test positive with the new diagnostic test and of the patients not diagnosed with DVT, 125 test positive with the new diagnostic test. What is the negative predictive value of this test:DVT YesDVT NoTotalPositive testa= 75b = 125200Negative testc = 2d = 798800Total779231000

      Your Answer: 0.375

      Correct Answer: 0.99

      Explanation:

      Negative predictive value (NPV) is the proportion of individuals with a negative test result who do not have the disease.Negative predictive value (NPV) = d/(c+d) = 798/800 = 0.99 = 99%This means there is a 99% chance, if the test is negative, that the patient does not have a DVT.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      50.3
      Seconds
  • Question 15 - 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
      26.8
      Seconds
  • Question 16 - Regarding bronchiolitis, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding bronchiolitis, which of the following statements is CORRECT:

      Your Answer: It most commonly affects children aged 3 - 4 years.

      Correct Answer: Chest x-ray may show hyperinflation and increased peribronchial markings.

      Explanation:

      Acute bronchiolitis is caused most commonly by respiratory syncytial virus, occurring mostly in children aged 6 months to 2 years. Children with bronchiolitis are febrile and tachypnoeic with a dry cough and difficulty feeding. Examination may reveal chest hyperinflation, respiratory distress, wheezing and fine end-inspiratory crepitations. Chest x-ray may show hyperinflation and increased peribronchial markings (although CXR should only performed if there is diagnostic uncertainty or an atypical course). Treatment is usually supportive, aerosolized ribavirin is reserved for severely ill or immunocompromised patients.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      16.2
      Seconds
  • Question 17 - The following statements about cross-sectional studies are true EXCEPT? ...

    Incorrect

    • The following statements about cross-sectional studies are true EXCEPT?

      Your Answer: An example of a cross-sectional study is the UK national census

      Correct Answer: They can be used to determine the relative risk of a condition

      Explanation:

      The UK national census is an example of a cross-sectional study.Cross-sectional studies can be used to assess the prevalence of a condition, and support or refute inferences of cause and effect.Cross-sectional studies are observations of the frequency and characteristics of a disease in a given population at one particular point in time. Cross-sectional studies do not differentiate between cause and effect and also do not establish the sequence of events.Cross-sectional studies cannot be used to calculate the relative risk of a condition.

    • This question is part of the following fields:

      • Evidence Based Medicine
      19.2
      Seconds
  • Question 18 - All of the following are indications for beta-blockers EXCEPT for: ...

    Correct

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

      Your 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
      10.3
      Seconds
  • Question 19 - A 40-year-old man with episodes of blood in urine and flank pain that...

    Incorrect

    • A 40-year-old man with episodes of blood in urine and flank pain that are recurrent presents for management. He has a history of hypertension that is difficult to control and recurrent urinary tract infections. Other findings are: bilateral masses in his flanks and haematuria (3+ on dipstick).What is the most likely diagnosis?

      Your Answer: Renal cell carcinoma

      Correct Answer: Polycystic kidney disease

      Explanation:

      Autosomal dominant polycystic kidney disease (ADPKD) presents with abdominal or loin discomfort due to the increasing size of the kidneys, acute loin pain with or without haematuria, hypertension, and male infertility. It is the most common cause of serious renal disease and the most common inherited cause of renal failure in adults. Alport syndrome has hearing loss and eye abnormalities in addition to symptoms of kidney disease.Renal cell carcinoma presents with additional features of unexplained weight loss, loss of appetite, fever of unknown origin and anaemia.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      27.5
      Seconds
  • Question 20 - Regarding dermatophytes, which of the following statement is CORRECT: ...

    Correct

    • Regarding dermatophytes, which of the following statement is CORRECT:

      Your Answer: Diagnosis is made from microscopy and culture of skin scrapings, hair samples or nail clippings.

      Explanation:

      Diagnosis is made from microscopy and culture of skin scrapings, hair samples or nail clippings depending on the site of infection. The lesions of ringworm typically have a dark outer ring with a pale centre. Tinea capitis is ringworm affecting the head and scalp. Spread is via direct skin contact. Treatment is usually topical, oral antifungals are reserved for refractory infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      87.7
      Seconds
  • Question 21 - Doxycycline is indicated first line for treatment of which of the following infections:...

    Correct

    • Doxycycline is indicated first line for treatment of which of the following infections:

      Your Answer: Chlamydia

      Explanation:

      Doxycycline may be used first line for chlamydia, pelvic inflammatory disease (with metronidazole and ceftriaxone), acute bacterial sinusitis, exacerbation of chronic bronchitis, moderate-severity community acquired pneumonia and high-severity community acquired pneumonia (with benzylpenicillin).

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      8.1
      Seconds
  • Question 22 - Which of the following is a contraindication to using nitrous oxide: ...

    Incorrect

    • Which of the following is a contraindication to using nitrous oxide:

      Your Answer: Third degree heart block

      Correct Answer: Raised intracranial pressure

      Explanation:

      Nitrous oxide should not be utilized in patients with an air-containing confined area because it diffuses into these spaces, causing a rise in pressure. This includes circumstances like pneumothorax, intracranial air after a head injury, imprisoned air from a recent undersea dive, a recent intraocular gas injection, or intestinal blockage. Nitrous oxide increases cerebral blood flow and should be avoided in individuals who have or are at risk of having high intracranial pressure.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      149.7
      Seconds
  • Question 23 - Anatomical barriers to infection include all of the following EXCEPT: ...

    Incorrect

    • Anatomical barriers to infection include all of the following EXCEPT:

      Your Answer: Irritant receptors causing the cough reflex

      Correct Answer: Mucociliary escalator in the gastrointestinal tract

      Explanation:

      Anatomical barriers to infection include:tight junctions between cells of the skin and mucosal membranesthe flushing action of tears, saliva and urinethe mucociliary escalator in the respiratory tract (together with the actions of coughing and sneezing)the acidic pH of gastric and vaginal secretionsthe acidic pH of the skin (maintained by lactic acid and fatty acids in sebum)enzymes such as lysozyme found in saliva, sweat and tearspepsin present in the stomachbiological commensal flora formed on the skin and the respiratory, gastrointestinal and genitourinary tracts which protect the host by competing with pathogenic bacteria for nutrients and attachment sites and by producing antibacterial substances

    • This question is part of the following fields:

      • Microbiology
      • Principles
      56.3
      Seconds
  • Question 24 - A 24-year-old student with red and painful right eye presents. Conjunctival erythema, mucopurulent...

    Incorrect

    • A 24-year-old student with red and painful right eye presents. Conjunctival erythema, mucopurulent discharge and lid crusting are seen on examination, and patient denies presence of itching of the eye. All his observations are normal, he has no fever and is otherwise well.Which of these is the most likely causative organism?

      Your Answer: Staphylococcus epidermidis

      Correct Answer: Haemophilus influenzae

      Explanation:

      The most frequent cause of red eye is conjunctivitis. It is caused by inflammation of the conjunctiva which can be infective or allergic and accounts for about 35% of all eye problems presenting to general practice.Viral conjunctivitis is commonly caused by adenoviruses and it is the most common infectious conjunctivitis.The common bacterial causes of conjunctivitis are Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.The clinical features of infective conjunctivitis include:Acute onset of conjunctival erythemaFeeling ‘grittiness’, ‘foreign body’ or ‘burning’ sensation in the eye.Watering and discharge which may cause transient blurring of visionThe discharge for viral conjunctivitis is less than that of bacterial conjunctivitis and usually watery.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      74.3
      Seconds
  • Question 25 - An analytical study is conducted to compare the risk of stroke between Ticagrelor...

    Incorrect

    • An analytical study is conducted to compare the risk of stroke between Ticagrelor therapy and Warfarin therapy among patients with atrial fibrillation. The following is obtained from the study:No. of patients who took Ticagrelor: 300No. of patients who took Ticagrelor and suffered a stroke: 30No. of patients who took Warfarin: 500No. of patients who took Warfarin and suffered a stroke: 20Compute for the risk ratio of a stroke.

      Your Answer: 5

      Correct Answer: 2.5

      Explanation:

      Relative risk (RR) is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.RR can be computed as the absolute risk of events in the treatment group (ART), divided by the absolute risk of events in the control group (ARC).RR = ART/ARCRR = (30/300) / (20/500)RR = 2.5Recall that:If RR < 1, then the intervention reduces the risk of the outcome.If RR = 1, then the treatment has no effect on the outcome.If RR > 1, then the intervention increases the risk of the outcome.

    • This question is part of the following fields:

      • Evidence Based Medicine
      40.5
      Seconds
  • Question 26 - A 47-year-old woman comes in with palpitations that have been bothering her for...

    Incorrect

    • A 47-year-old woman comes in with palpitations that have been bothering her for the past four days. Her haemodynamics are normal, but her heart rate is currently 150 beats per minute. An ECG is performed, which reveals that she is experiencing atrial flutter. The patient is examined by a cardiology registrar, who recommends starting her on verapamil to control her ventricular rate while she waits for cardioversion.In these circumstances, which of the following is a contraindication to the use of verapamil?

      Your Answer: Aortic stenosis

      Correct Answer: Acute porphyria

      Explanation:

      In most cases of atrial flutter, ventricular rate control is used as a stopgap measure until sinus rhythm is restored. A beta-blocker (e.g. bisoprolol), diltiazem, or verapamil can be used to reduce the rate of contractions in the heart.Electrical cardioversion, pharmacological cardioversion, and catheter ablation can all be used to return the heart to a normal rhythm. Cardioversion should not be attempted until the patient has been fully anticoagulated for at least three weeks if the duration of atrial flutter is unknown or it has lasted longer than 48 hours. Emergency electrical cardioversion is the treatment of choice when there is a sudden onset of symptoms and haemodynamic compromise. For recurrent atrial flutter, catheter ablation is preferred.Verapamil is a calcium-channel blocker that is non-dihydropyridine phenylalkylamine and can be used to treat supraventricular arrhythmias. It’s a calcium channel blocker with a high negative inotropic effect that lowers cardiac output, slows the heart rate, and may impair atrioventricular conduction. At high doses, it can cause heart failure, exacerbate conduction disorders, and cause hypotension.Adults should take 240-480 mg of verapamil in 2-3 divided doses. 5-10 mg IV over 30 seconds is the corresponding intravenous (IV) dose. After an IV injection, the peak effect lasts 3-5 minutes, and the action lasts 10-20 minutes.Verapamil should not be taken with beta-blockers like atenolol or quinidine because the combination of their negatively inotropic and negatively chronotropic effects can result in severe hypotension, bradycardia, impaired atrioventricular conduction, heart failure (due to impaired cardiac contractility), and sinus arrest.The use of verapamil is contraindicated in the following situations:Acute porphyrias are a type of porphyria that occurs suddenly.Accessory conducting pathways are linked to atrial flutter or fibrillation (e.g. Wolff-Parkinson-White-syndrome)BradycardiaShock caused by the heartInsufficiency of the heart (with reduced ejection fraction)Left ventricular function has been significantly harmed in the past (even if controlled by therapy)Hypotension (blood pressure less than 90 mmHg)AV block in the second and third degreesSinusitis is a condition in which the sinuses becomeSino-atrial occlusion

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      65.2
      Seconds
  • Question 27 - Which of the following blood groups is the universal donor: ...

    Incorrect

    • Which of the following blood groups is the universal donor:

      Your Answer: B

      Correct Answer: O

      Explanation:

      Blood group O has no antigens, but both anti-A and anti-B antibodies and thus is the universal donor.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      6.7
      Seconds
  • Question 28 - What type of visual field defect are you likely to see in a...

    Correct

    • What type of visual field defect are you likely to see in a lesion of the visual cortex:

      Your Answer: Contralateral homonymous hemianopia with macular sparing

      Explanation:

      A lesion of the visual cortex will result in a contralateral homonymous hemianopia with macular sparing.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      17.1
      Seconds
  • Question 29 - Which lobe of the prostate gland is most commonly affected in benign prostatic...

    Incorrect

    • Which lobe of the prostate gland is most commonly affected in benign prostatic hypertrophy?

      Your Answer: Posterior

      Correct Answer: Median

      Explanation:

      Benign enlargement of the prostate is common in men older than 50 years. The cause is possibly an imbalance in the hormonal control of the gland. The median lobe of the gland enlarges upward and encroaches within the sphincter vesicae, located at the neck of the bladder. The leakage of urine into the prostatic urethra causes an intense reflex desire to micturate. The enlargement of the median and lateral lobes of the gland produces elongation and lateral compression and distortion of the urethra so that the patient experiences difficulty in passing urine and the stream is weak. Back-pressure effects on the ureters and both kidneys are a common complication. The enlargement of the uvula vesicae (owing to the enlarged median lobe) results in the formation of a pouch of stagnant urine behind the urethral orifice within the bladder. The stagnant urine frequently becomes infected, and the inflamed bladder (cystitis) adds to the patient’s symptoms.In all operations on the prostate, the surgeon regards the prostatic venous plexus with respect. The veins have thin walls, are valveless, and are drained by several large trunks directly into the internal iliac veins. Damage to these veins can result in a severe haemorrhage.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      10.6
      Seconds
  • Question 30 - Regarding apoptosis, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer: Apoptosis may be induced by TNF-alpha.

      Correct Answer: Apoptosis leads to cell swelling and eventual cell lysis.

      Explanation:

      Apoptosis is a controlled form of cell death in which no cellular contents are released from the dying cell, and thus no inflammatory reaction is seen. Apoptosis may occur physiologically or pathologically. Apoptosis may be induced in two main ways: by the engagement of surface death receptors e.g. TNF-alpha (extrinsic pathway) or through cellular injury (intrinsic pathway). The end result is the activation of proteases enzymes called caspases which dismantle the cell cytoplasm and nucleus. Apoptotic cells shrink down and fragment into apoptotic bodies, each of which retains an intact cell membrane; apoptotic bodies are then targeted or rapid removal by adjacent cells. Disordered apoptosis is thought to be central to a number of important disease processes, particularly carcinogenesis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
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