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  • Question 1 - Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT...

    Incorrect

    • Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT for:

      Your Answer: Varicella-zoster

      Correct Answer: Hepatitis A

      Explanation:

      Disease specific immunoglobulins are available for:hepatitis Brabiestetanusvaricella-zosterNormal immunoglobulin can be used to confer protection against hepatitis A.

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      22.2
      Seconds
  • Question 2 - Regarding linear relationships between two variables, what does a positive correlation coefficient indicate:...

    Correct

    • Regarding linear relationships between two variables, what does a positive correlation coefficient indicate:

      Your Answer: The two variables are directly proportional

      Explanation:

      A positive correlation coefficient means that the two variables are directly proportional e.g. height and weight in healthy growing children.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      18.7
      Seconds
  • Question 3 - A young patient presents with the features of an easily recognisable infectious disease.Which...

    Correct

    • A young patient presents with the features of an easily recognisable infectious disease.Which of the following infectious diseases typically has an incubation period of less than 1 week? Select ONE answer only.

      Your Answer: Cholera

      Explanation:

      Cholera has an incubation period of 12 hours to 6 days.Other infectious disease that have an incubation period of less than 1 week include:Staphylococcal enteritis (1-6 hours)Salmonella enteritis (12-24 hours)Botulism (18-36 hours)Gas gangrene (6 hours to 4 days)Scarlet fever (1-4 days)Diphtheria (2-5 days)Gonorrhoea (3-5 days)Yellow fever (3-6 days)Meningococcaemia (1-7 days)Brucellosis has an incubation period of 7-21 days.Measles has an incubation period of 14-18 days.Falciparum malaria usually has an incubation period of 7-14 days. The other forms of malaria have a longer incubation period of 12-40 days.Rubella has an incubation period of 14-21 days.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      166.7
      Seconds
  • Question 4 - Which of the following is most true of the sinoatrial node: ...

    Correct

    • Which of the following is most true of the sinoatrial node:

      Your Answer: Frequency of depolarisation is increased by sympathetic stimulation.

      Explanation:

      Cardiac myocyte contraction is not dependent on an external nerve supply but instead the heart generates its own rhythm, demonstrating inherent rhythmicity. The heartbeat is initiated by spontaneous depolarisation of the sinoatrial node (SAN), a region of specialised myocytes in the right atrium close to the coronary sinus, at a rate of 100-110 beats/min. This intrinsic rhythm is primarily influenced by autonomic nerves, with vagal influences being dominant over sympathetic influences at rest. This vagal tone reduces the resting heart rate down to 60-80 beats/min. To increase heart rate, the autonomic nervous system increases sympathetic outflow to the SAN, with concurrent inhibition of vagal tone. These changes mean the pacemaker potential more rapidly reaches the threshold for action potential generation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      12.7
      Seconds
  • Question 5 - The risk of renal impairment in a patient on ACE inhibitor therapy is...

    Correct

    • The risk of renal impairment in a patient on ACE inhibitor therapy is increased by concomitant treatment with which of the following drug classes:

      Your Answer: NSAIDs

      Explanation:

      Concomitant treatment with NSAIDs increases the risk of renal damage, and with potassium-sparing diuretics (or potassium-containing salt substitutes) increases the risk of hyperkalaemia. Hyperkalaemia and other side effects of ACE inhibitors are more common in the elderly and in those with impaired renal function and the dose may need to be reduced.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      26.3
      Seconds
  • Question 6 - A 66-year-old patient attends the Emergency Department with chest pain. His ECG and...

    Correct

    • A 66-year-old patient attends the Emergency Department with chest pain. His ECG and troponin are suggestive of a new myocardial infarction. You have explained the condition and the prognosis. He asks you about how the damaged area of his heart will heal following this.Which answer best describes the process of myocardial healing following myocardial infarction? Select ONE answer only.

      Your Answer: The damaged myocardium will form non-contractile scar tissue

      Explanation:

      Myocardial cells are unable to regenerate, they are unable to divide in response to tissue injury. The remain permanently in G0 and cannot progress to G1. If a segment of muscle dies, for example in myocardial infarction, this tissue will be replaced by scar tissue if the patient recovers. This scar tissue is non-contractile and therefore the remaining myocardium must work harder to maintain cardiac output. As a consequence the remaining undamaged myocardium undergoes compensatory hypertrophy without cell division.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      56.8
      Seconds
  • Question 7 - Regarding Campylobacter gastroenteritis, which of the following statements is INCORRECT: ...

    Correct

    • Regarding Campylobacter gastroenteritis, which of the following statements is INCORRECT:

      Your Answer: Infection usually requires antibiotic treatment.

      Explanation:

      Campylobacter jejuni is the primary human pathogen, typically causing dysentery (bloody diarrhoea illness) following ingestion of contaminated meat, especially poultry. Infection is typically self-limiting and does not require antibiotic therapy. Campylobacter gastroenteritis is associated with the immune-mediated complications of Guillain-Barre syndrome, reactive arthritis and Reiter’s syndrome.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      39.6
      Seconds
  • Question 8 - A 60-year-old man diagnosed with chronic kidney disease has an elevated creatinine level...

    Incorrect

    • A 60-year-old man diagnosed with chronic kidney disease has an elevated creatinine level and a reduced glomerular filtration rate (GFR).Which statement concerning glomerular filtration is true?

      Your Answer: The GFR declines with age after the age of 40 at a rate of approximately 5 ml/min/year

      Correct Answer: Creatinine is freely filtered at the glomerulus

      Explanation:

      Glomerular filtration is a passive process. It depends on the net hydrostatic pressure across the glomerular capillaries, the oncotic pressure, and the intrinsic permeability of the glomerulus.The mean values for glomerular filtration rate (GFR) in young adults are 130 ml/min/1.73m2 in males and 120 ml/min/1.73m2in females.The GFR declines with age after the age of 40 at a rate of approximately 1 ml/min/year.The Cockcroft and Gault formula overestimates creatinine in obese patients. This is because their endogenous creatinine production is less than that predicted by overall body weight.Creatinine is used in the estimation of GFR because it is naturally produced by muscle breakdown, not toxic, not produced by the kidney, freely filtered at the glomerulus, not reabsorbed from the nephron, and does not alter GFR.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      61.2
      Seconds
  • Question 9 - Atracurium is used as a muscle relaxant during endotracheal intubation. This drug’s mechanism...

    Correct

    • Atracurium is used as a muscle relaxant during endotracheal intubation. This drug’s mechanism of action is best described by which of the following?

      Your Answer: Nicotinic acetylcholine receptor antagonist

      Explanation:

      Atracurium is a non-depolarizing neuromuscular blocker that is used to help with intubation and controlled ventilation by causing muscle relaxation and paralysis. At the neuromuscular junction’s post-synaptic membrane, atracurium competes with acetylcholine for nicotinic (N2) receptor binding sites. This prevents the receptors from being stimulated by acetylcholine. Muscle paralysis occurs gradually due to the competitive blockade.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      13.7
      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
      16.7
      Seconds
  • Question 11 - Regarding benzodiazepines, which of the following statements is INCORRECT: ...

    Correct

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

      Your 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
      29.3
      Seconds
  • Question 12 - A 69-year-old man with a history of chronic anaemia is transfused. He takes...

    Correct

    • A 69-year-old man with a history of chronic anaemia is transfused. He takes bisoprolol and furosemide for his cardiac failure, and his most recent BNP was 123 pmol/l. He developed shortness of breath and his pre-existing peripheral oedema became worse 5 hours after transfusion was commenced. His BP rises to 170/105 mmHg and a repeat measurement of his BNP is 192 pmol/l.What is the most likely transfusion reaction to have occurred?

      Your Answer: TACO

      Explanation:

      Transfusion-associated circulatory overload (TACO) presents as acute or worsening respiratory distress within 6 hours of transfusion of a large volume of blood. It is common in patients with diminished cardiac reserve or chronic anaemia. Elderly patients, infants and severely anaemic patients are particularly susceptible. Typical clinical features of TACO include: Acute respiratory distress, Tachycardia, Hypertension, Acute/worsening pulmonary oedema on chest X-ray. The BNP is usually raised to at least 1.5 times the pre-transfusion baseline.Febrile transfusion reaction presents with a 1 degree rise in temperature from baseline during transfusion. Patient may have chills and malaise. It is the most common transfusion reaction (1 in 8 transfusions) and is usually caused by cytokines released from leukocytes in transfused red cell or platelet components. TRALI (Transfusion Related Acute Lung Injury) is a clinical syndrome with abrupt onset of non-cardiogenic pulmonary oedema within 6 hours of transfusion not explained by another risk factor. Associated with the presence of antibodies in the donor blood to recipient leukocyte antigens. patients present with dyspnoea, hypertension, hypotension, acute leukopenia. Graft versus host disease(GVHD) is an immune mediated condition that arises from a complex interaction between donor and recipients adaptive immunity. It presents as dermatitis, hepatitis and enteritis developing within 100 days after stem cell or bone marrow transplant.Acute haemolytic reaction aka immediate haemolytic transfusion reaction presents with fever, chills, pain at transfusion site, nausea, vomiting, dark urine and feeling of ‘impending doom’. Often, it occurs due to ABO incompatibility.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      45.4
      Seconds
  • Question 13 - You come across a 60-year-old woman with a history of chronic pancreatitis. Today...

    Incorrect

    • You come across a 60-year-old woman with a history of chronic pancreatitis. Today she is complaining of epigastric pain. She has blood tests done especially to review her cholecystokinin levels.Which of the following is a cholecystokinin (CCK) releasing site? 

      Your Answer: G-cells in the gastric antrum

      Correct Answer: I-cells in the upper small intestine

      Explanation:

      The I-cells in the duodenum generate and release cholecystokinin (CCK), a peptide hormone. It has a crucial role in the digestion process as a hormonal regulator.CCK cells are concentrated in the proximal small intestine, and when food is consumed, the hormone is produced into the bloodstream. The presence of partly digested lipids and proteins in the duodenum is one of the most powerful stimulus for CCK synthesis.CCK’s key physiological effects include:Encourages the pancreas to release digesting enzymes into the small intestine.Stimulates gallbladder contraction and sphincter of Oddi relaxation, resulting in bile delivery into the duodenum.Gastric emptying is inhibited, and gastric acid output is reduced.Satiety induction is a process that involves inducing a feeling of fullness.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      38.5
      Seconds
  • Question 14 - Regarding the intervertebral disc, which of the following statements is CORRECT: ...

    Correct

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

      Your 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
      31.5
      Seconds
  • Question 15 - The patients listed below have been diagnosed with a variety of ailments.In which...

    Incorrect

    • The patients listed below have been diagnosed with a variety of ailments.In which of the following situations would aspirin be an effective treatment option?

      Your Answer: A 50-year-old with an acute exacerbation of gout

      Correct Answer: A 36-year-old with an acute migraine (dose of 900-1000 mg)

      Explanation:

      A study published in the Cochrane Database of Systematic Reviews in 2010 found that a single 1000-mg dose of aspirin is effective in treating acute migraine. It was discovered that 24 percent of aspirin users were pain-free after two hours, compared to 11 percent of placebo users. Because the BNF recommends a maximum dose of 900 mg for analgesia and most non-proprietary aspirin in the UK comes in a dose of 300 mg, a dose of 900 mg is frequently prescribed in the UK.Because aspirin is not recommended for children under the age of 16 due to the risk of Reye’s syndrome, it would be inappropriate to give it to the 12-year-old with the viral URTI.For uncomplicated dental pain, aspirin is an acceptable option, but not for patients who are taking warfarin. The combination of aspirin’s antiplatelet action and warfarin’s anticoagulation properties puts the patient at high risk of bleeding. Furthermore, aspirin can deplete the therapeutic levels of warfarin by displacing it from plasma proteins. It would be better to use another NSAID or analgesic.In gout, aspirin should be avoided because it reduces urate clearance in the urine and interferes with the action of uricosuric agents. Naproxen, diclofenac, and indomethacin are better options.Although aspirin is useful for inflammatory pains, the dose of aspirin required for an adequate analgesic effect in severe pain is associated with significant side effects. Naproxen would be a better first-line treatment option.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      68.2
      Seconds
  • Question 16 - An 80-year-old male has presented with chest pain characteristic of angina pectoris. Before...

    Incorrect

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

      Your Answer: Aortic regurgitation

      Correct Answer: Mitral stenosis

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      59.1
      Seconds
  • Question 17 - 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
      18.7
      Seconds
  • Question 18 - You received a patient with a 2-day history of diarrhoea and vomiting. Later,...

    Correct

    • You received a patient with a 2-day history of diarrhoea and vomiting. Later, after examination, the patient was found to have progressive symmetric descending flaccid paralysis, initial development of blurred vision, dysphagia, and weakness of the upper limbs. The patient is apyrexial and his observations are all normal. Which of the following pathogens is responsible for the said symptoms?

      Your Answer: Clostridium botulinum

      Explanation:

      A botulism infection results in neuroparalysis caused by the neurotoxin generated by Clostridium botulinum. Food-borne botulism symptoms often appear 12-36 hours after ingestion of the toxin-containing food and may include nausea, vomiting, stomach discomfort, and diarrhoea at first. The most common neurological pattern is an acute onset of bilateral cranial neuropathies with symmetric declining weakening. Other distinguishing characteristics include the absence of fever, the absence of cognitive abnormalities, the presence of a normal heart rate and blood pressure, and the absence of sensory defects.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      27.1
      Seconds
  • Question 19 - Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that...

    Incorrect

    • Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus.Which ONE of these statements about ANAs is true?

      Your Answer: Anti-Ro antibodies are associated with CREST syndrome

      Correct Answer: They can be of any immunoglobulin class

      Explanation:

      Anti-nuclear antibodies(ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus. They can be of any immunoglobulin class.CREST syndrome is usually associated with anti-centromere antibodies.ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most reliable.Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.Anti-dsDNA antibodies are found in 80 – 90% of patients with SLE

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      43.7
      Seconds
  • Question 20 - Regarding Clostridium perfringens, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: It has endotoxin-mediated effects in tissue causing severe tissue damage.

      Correct Answer: It can cause exotoxin-mediated food poisoning.

      Explanation:

      Clostridium perfringens is an obligate anaerobe and has exotoxin mediated effects. It is the most common cause of gas gangrene. C. perfringens is also implicated in food poisoning, cellulitis, enteritis necrotican (life-threatening infection involving ischaemic necrosis of the jejunum), and rarely, CNS infections such as meningitis and encephalitis.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      20
      Seconds
  • Question 21 - A 35-year-old man presents with haemoptysis, night sweats, and weight loss. Further examinations...

    Incorrect

    • A 35-year-old man presents with haemoptysis, night sweats, and weight loss. Further examinations were done and a diagnosis of tuberculosis is suspected. Which of the following statements is considered correct regarding Mycobacterium tuberculosis?

      Your Answer: Approximately 90% of patients will develop post-primary tuberculosis

      Correct Answer: It is impervious to decolourisation with acid

      Explanation:

      Mycobacterium tuberculosis are part of the Mycobacteriaceae family. They are described to have the characteristics of a Gram-positive cell wall but they are not easily stained with Gram stain. This is because their cell wall contains a high lipid content, and this lipid allows the Mycobacteria to bind to alkaline stains with the application and help of heat. Once stained, they are able to resist decolorization even with the use of acid alcohol as the decolourizer, making them very difficult to decolorize, that is why they are known to be acid-fast.The Ghon complex is a non-pathognomonic radiographic finding on a chest x-ray that is significant for pulmonary infection of tuberculosis. The location of the Ghon’s focus is usually subpleural and predominantly in the upper part of the lower lobe and lower part of the middle or upper lobe. Skeletal tuberculosis of the spine is referred to as Pott disease.The risk of reactivation TB is about 3.3% during the first year after a positive PPD skin test and a total of 5% to 15% thereafter in the person’s lifetime. Progression from infection to active disease varies with age and the intensity and duration of exposure. Reactivation TB occurs when there is an alteration or suppression of the cellular immune system in the infected host that favoursreplication of the bacilli and progression to disease.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      44.2
      Seconds
  • Question 22 - 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: Viral infections

      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
      25.2
      Seconds
  • Question 23 - The Frank-Starling curve is shifted downhill in heart failure due to which of...

    Correct

    • The Frank-Starling curve is shifted downhill in heart failure due to which of the following?

      Your Answer: Decrease in contractility

      Explanation:

      The Frank–Starling mechanism states that the left ventricle can increase its force of contraction and hence stroke volume in response to increases in venous return and thus preload. Changes in afterload or inotropy cause the Frank–Starling curve to rise or fall. In heart failure, the Frank–Starling curve is shifted downward (flattened), requiring higher venous return and filling pressure to enhance contractility and stroke volume.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      12.1
      Seconds
  • Question 24 - A patient suffers from an injury and as a consequence, the nerve that...

    Correct

    • A patient suffers from an injury and as a consequence, the nerve that was damaged innervates the obturator internus muscle.In which of the following nerves is the obturator internus muscle innervated by?

      Your Answer: Nerve to obturator internus

      Explanation:

      The obturator internus is innervated by the obturator internus nerve (L5–S2), a branch of sacral plexus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      13.3
      Seconds
  • Question 25 - Monoamine oxidase is primarily involved in the degradation of which of the following:...

    Incorrect

    • Monoamine oxidase is primarily involved in the degradation of which of the following:

      Your Answer: Acetylcholine

      Correct Answer: Noradrenaline

      Explanation:

      Catecholamines are broken down extracellularly and in the liver by catechol-O-methyltransferase (COMT) and intracellularly by monoamine oxidase (MAO).

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      25.2
      Seconds
  • Question 26 - A young farmer who is caught under farm machinery and suffering from a...

    Incorrect

    • A young farmer who is caught under farm machinery and suffering from a major crush injury is taken to the emergency department and requires a quick induction sequence. In this type of injury, which of the following anaesthetic medicines should be avoided?

      Your Answer: Propofol

      Correct Answer: Suxamethonium

      Explanation:

      Suxamethonium is a neuromuscular blocker. It is contraindicated in patients who have experienced massive trauma, hyperkalemic, or burn injuries.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      37.1
      Seconds
  • Question 27 - A 34-year-old man arrives at the department befuddled. He has a history of...

    Correct

    • A 34-year-old man arrives at the department befuddled. He has a history of schizophrenia and is on an antipsychotic medication, but he can't recall what it's called.Which of the following statements about antipsychotic drug side effects is correct?

      Your Answer: Haloperidol is the most common causative antipsychotic drug

      Explanation:

      Extrapyramidal side effects are most common with piperazine phenothiazines (fluphenazine, prochlorperazine, and trifluoperazine) and butyrophenones (fluphenazine, prochlorperazine, and trifluoperazine) (benperidol and haloperidol). The most common causative antipsychotic drug is haloperidol.Tardive dyskinesia (rhythmic, involuntary movements of the tongue, face, and jaw) is most commonly associated with long-term or high-dose treatment. It is the most serious form of extrapyramidal symptoms because withdrawal of the causative drug may make it irreversible, and treatment is usually ineffective.Dystonia (abnormal facial and body movements) is more common in children and young adults, and it usually shows up after only a few doses. Procyclidine 5 mg IV or benzatropine 2 mg IV as a bolus can be used to treat acute dystonia.An unpleasant feeling of restlessness characterises akathisia. The inability to initiate movement is known as akinesia.Renal impairment causes increased cerebral sensitivity, so lower doses should be used.In elderly patients with dementia-related psychosis who are treated with haloperidol, there is an increased risk of death. This appears to be due to a higher risk of heart attacks and infections like pneumonia.The following are some of the antipsychotic drugs’ contraindications:Reduced level of consciousness/comaDepression of the central nervous systemPhaeochromocytoma

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      38.5
      Seconds
  • Question 28 - A 45-year old man presented to the emergency room with complains of chest...

    Incorrect

    • A 45-year old man presented to the emergency room with complains of chest pain and breathlessness. Upon history taking and examination, it was discovered that he had a right-sided spontaneous pneumothorax and had a failed attempt at pleural aspiration. The pneumothorax is still considerable in size, but he remains breathless. A Seldinger chest drain was inserted but it started to drain frank blood shortly after. Which of the following complications is most likely to have occurred?

      Your Answer: Pulmonary artery laceration

      Correct Answer: Intercostal artery laceration

      Explanation:

      Injury to the intercostal artery (ICA) is an infrequent but potentially life-threatening complication of all pleural interventions. Traditional anatomy teaching describes the ICA as lying in the intercostal groove, protected by the flange of the rib. This is the rationale behind the recommendation to insert needles just above the superior border of the rib. Current recommendations for chest drain insertion suggest that drains should be inserted in the ‘safe triangle’ in order to avoid the heart and the mediastinum and be above the level of the diaphragm. The safe triangle is formed anteriorly by the lateral border of the pectoralis major, laterally by the lateral border of the latissimus dorsi, inferiorly by the line of the fifth intercostal space and superiorly by the base of the axilla. Imaging guidance also aids in the safety of the procedure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      59
      Seconds
  • Question 29 - A 42-year-old woman with a history of hyposplenism arrives at the Emergency Department...

    Incorrect

    • A 42-year-old woman with a history of hyposplenism arrives at the Emergency Department sick and feverish. A complete set of bloods, including a peripheral blood film, is organised.On a hyposplenic blood film, which of the following features is LEAST likely to be seen?

      Your Answer: Macrocytosis

      Correct Answer: Teardrop cells

      Explanation:

      The collection of abnormalities found in these patients is referred to as a hyposplenic film.The following features can be seen on hyposplenic blood films:Howell-Jolly bodiesHeinz’s bodiesTarget cellsRBCs with nuclei on occasionLymphocytosisMacrocytosisAcanthocytesTeardrop cells, also known as dacrocytes, are named for their teardrop-shaped shape. Dacrocytosis is a condition in which a large number of these cells are present. Myelofibrosis and beta thalassemia major both have dacrocytes, but hyposplenism does not.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      37.9
      Seconds
  • Question 30 - You are giving a presentation on the immune system as part of your...

    Incorrect

    • You are giving a presentation on the immune system as part of your peer-to-peer teaching sessions. Yu are currently discussing phagocytes. Macrophages are derived from which of the following cells:

      Your Answer: Plasma cells

      Correct Answer: Monocytes

      Explanation:

      Monocytes spend only a short time in the marrow and, after circulating for 20-40 hours, leave the blood to enter the tissues where they become macrophages. Macrophages form the reticuloendothelial system in the liver, spleen and lymph nodes. The lifespan of macrophages may be as long as several months or even years. In tissues the macrophages become self-replicating without replenishment from the blood. They assume specific functions in different tissues e.g. dendritic cells which are involved in antigen presentation to T-cells. Macrophages may be activated by cytokines such as IFN-gamma, contact with complement or direct contact with the target cell through leucocyte adhesion molecules.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      17.1
      Seconds

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