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  • Question 1 - Which of the following is the most likely causative organism of acute epiglottitis...

    Correct

    • Which of the following is the most likely causative organism of acute epiglottitis in a 6 year old?

      Your Answer: Streptococcus pneumoniae

      Explanation:

      Since the introduction of the HIB vaccine, most cases of acute epiglottitis are now caused by Streptococcus spp. The condition is now rare in children.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      4.2
      Seconds
  • Question 2 - Regarding Clostridium tetani, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: Germination and outgrowth of clostridial spores depends on anaerobic conditions.

      Explanation:

      Clostridium tetani is found in normal human intestinal flora, although infection is predominantly exogenous. Tetanospasmin, an exotoxin produced by C. tetani is responsible for the neurotoxic effects of tetanus, largely by preventing the release of the inhibitory neurotransmitter GABA, resulting in prolonged excitation. Clostridium tetani is an obligate anaerobe, with an incubation period of about 3 – 21 days (average 10 days).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      11.2
      Seconds
  • Question 3 - Which of the following is NOT a typical clinical feature of osteomalacia: ...

    Correct

    • Which of the following is NOT a typical clinical feature of osteomalacia:

      Your Answer: Hypercalcaemia

      Explanation:

      Features of osteomalacia include: Bone pain (particularly bone, pelvis, ribs)Neuromuscular dysfunction (particularly in the gluteal muscles, leading to waddling gaitPseudofractures on x-ray (looser zones)Elevated alkaline phosphatase, hypocalcaemia and low phosphate due to secondary hyperparathyroidism

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      3.4
      Seconds
  • Question 4 - 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: 2,4,5,1,3

      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
      10.5
      Seconds
  • Question 5 - In the emergency department, a 50-year-old female appears with a lack of sensation...

    Correct

    • In the emergency department, a 50-year-old female appears with a lack of sensation over the front two-thirds of her tongue. Taste and salivation are both present. The patient might have damage which of her nerves?

      Your Answer: Lingual nerve

      Explanation:

      The lingual nerve, a branch of the mandibular nerve, transmits sensation to the anterior two-thirds of the tongue. The chorda tympani, a branch of the facial nerve, transmits taste to the front two-thirds of the tongue as well as secretomotor innervation to the submandibular and sublingual glands. As a result, any damage to the lingual nerve can cause changes in salivary secretion on the affected side, as well as a loss of taste in the anterior two-thirds of the tongue and temporary or permanent sensory changes in the anterior two-thirds of the tongue and the floor of the mouth.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      2.9
      Seconds
  • Question 6 - An ambulance transports a 72-year-old woman to the Emergency Department. She is confused,...

    Correct

    • An ambulance transports a 72-year-old woman to the Emergency Department. She is confused, has been vomiting and having stomach pains. Digoxin is one of her medications.Which of the following claims about digoxin is correct?

      Your Answer: Therapeutic plasma levels are between 1.0-1.5 nmol/l

      Explanation:

      Digoxin is a cardiac glycoside that is used to treat atrial fibrillation and flutter, as well as congestive heart failure. In cardiac myocytes, it works by inhibiting the membrane Na/K ATPase. Through Na/Ca exchange, this raises intracellular sodium concentration and indirectly increases intracellular calcium availability. Increased intracellular calcium levels have both a positive inotropic and negative chronotropic effect.Digoxin therapeutic plasma levels are typically between 1.0 and 1.5 nmol/l, though higher concentrations may be required, and the value varies between laboratories. At concentrations greater than 2 nmol/l, the risk of toxicity increases dramatically.In patients with normal renal function, digoxin has a long plasma half-life of 36 to 48 hours. This can take up to 5 days in patients with impaired renal function.Hypokalaemia, rather than hyperkalaemia, has been shown to increase the risk of digoxin toxicity.In the treatment of persistent and permanent atrial fibrillation, digoxin is no longer widely used. Beta-blockers, also known as rate-limiting calcium channel blockers, are now the first-line treatment for this condition.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      3.5
      Seconds
  • Question 7 - A patient presents with a history of renal problems, generalised weakness and palpitations....

    Correct

    • A patient presents with a history of renal problems, generalised weakness and palpitations. Her serum potassium levels are measured and come back at 6.2 mmol/L. An ECG is performed, and it shows some changes that are consistent with hyperkalaemia.Which of the following ECG changes is usually the earliest sign of hyperkalaemia? Select ONE answer only.

      Your Answer: Peaked T waves

      Explanation:

      Hyperkalaemia causes a rapid reduction in resting membrane potential leading to increased cardiac depolarisation and muscle excitability. This in turn results in ECG changes which can rapidly progress to ventricular fibrillation or asystole. Very distinctive ECG changes that progressively change as the K+level increases:K+>5.5 mmol/l – peaked T waves (usually earliest sign of hyperkalaemia), repolarisation abnormalitiesK+>6.5 mmol/l – P waves widen and flatten, PR segment lengthens, P waves eventually disappearK+>7.0 mmol/l – Prolonged QRS interval and bizarre QRS morphology, conduction blocks (bundle branch blocks, fascicular blocks), sinus bradycardia or slow AF, development of a sine wave appearance (a pre-terminal rhythm)K+>9.0 mmol/l – Cardiac arrest due to asystole, VF or PEA with a bizarre, wide complex rhythm.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      3
      Seconds
  • Question 8 - A patient presents with an adducted eye at rest which cannot abduct past...

    Incorrect

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

      Your Answer: Oculomotor nerve

      Correct Answer: Abducens nerve

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      22.8
      Seconds
  • Question 9 - The myocardium is responsible for creating the force with which the atrial and...

    Correct

    • The myocardium is responsible for creating the force with which the atrial and ventricular muscles contract. It is made up of myocytes, which are heart muscle cells.Which of the following statements about cardiac muscle anatomy is correct? 

      Your Answer: Cardiac myocytes have intercalated discs

      Explanation:

      Typically, granuloma has Langerhan’s cells (large multinucleated cells ) surrounded by epithelioid cell aggregates, T lymphocytes and fibroblasts.Antigen presenting monocytic cells found in the skin are known as Langerhan’s cells.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      51.7
      Seconds
  • Question 10 - Regarding Campylobacter gastroenteritis, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer: It is associated with the subsequent development of Reiter's syndrome.

      Correct 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
      28
      Seconds
  • Question 11 - Which of the following statements is correct with regards to Horner's syndrome? ...

    Incorrect

    • Which of the following statements is correct with regards to Horner's syndrome?

      Your Answer: Horner's syndrome results from damage to secretomotor parasympathetic fibres.

      Correct Answer: Miosis occurs due to paralysis of the dilator pupillae muscle.

      Explanation:

      The characteristics of Horner’s syndrome are pupil constriction, partial ptosis and anhidrosis.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      21.1
      Seconds
  • Question 12 - A 49-year-old woman with haemoglobin of 6 g/dL following persistent vaginal bleeding receives...

    Correct

    • A 49-year-old woman with haemoglobin of 6 g/dL following persistent vaginal bleeding receives blood transfusion. She developed pain and burning at her cannula site and complains of a feeling of “impending doom”, nausea, and severe back pain shortly after transfusion was started. Her temperature is 38.9ºC.What is the most appropriate treatment?

      Your Answer: Stop the transfusion and administer IV fluids

      Explanation:

      Acute haemolytic transfusion reactions present with: Feeling of ‘impending doom’ as the earliest symptom, fever and chills, pain and warmth at transfusion site, nausea and vomiting, back, joint, and chest pain. Transfusion should be stopped immediately and IV fluid (usually normal saline) administered.Supportive measures and paracetamol can be given since patient has fever but it is not the immediate first step.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      38.4
      Seconds
  • Question 13 - After collapsing at home, a 62-year-old man is transported in an ambulance. He...

    Correct

    • After collapsing at home, a 62-year-old man is transported in an ambulance. He is now awake, but he is experiencing palpitations and chest pain. He is rushed to resuscitation and placed on a cardiac monitor, which reveals ventricular tachycardia. An amiodarone infusion is set up.Which of these statements about amiodarone is correct?

      Your Answer: It is expressed in breast milk

      Explanation:

      Antiarrhythmic drug amiodarone is used to treat both ventricular and atrial arrhythmias. It’s a class III antiarrhythmic that works by prolonging the repolarization phase of the cardiac action potential, where potassium permeability is normally high and calcium permeability is low.Dronedarone is sometimes used instead of amiodarone in certain situations. Although amiodarone is more effective than dronedarone, dronedarone has fewer side effects.Grapefruit juice inhibits the metabolism of amiodarone.The plasma half-life of amiodarone is very long, ranging from 2 weeks to 5 months. The half-life is about 2 months on average.Because amiodarone is excreted in breast milk, it should be avoided by breastfeeding mothers.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      61
      Seconds
  • Question 14 - A 65-year-old man presents with a red, hot, swollen great toe. A diagnosis...

    Correct

    • A 65-year-old man presents with a red, hot, swollen great toe. A diagnosis of acute gout is made. His past medical history includes heart failure and type 2 diabetes mellitus.Which of the following is the most appropriate medication to use in the treatment of his gout? Select ONE answer only.

      Your Answer: Colchicine

      Explanation:

      In the absence of any contra-indications, high-dose NSAIDs are the first-line treatment for acute gout. Naproxen 750 mg as a stat dose followed by 250 mg TDS is a commonly used and effective regime.Aspirin should not be used in gout as it reduces the urinary clearance of urate and interferes with the action of uricosuric agents. Naproxen, Diclofenac or Indomethacin are more appropriate choices.Allopurinol is used prophylactically, preventing future attacks by reducing serum uric acid levels. It should not be started in the acute phase as it increases the severity and duration of symptoms.Colchicine acts on the neutrophils, binding to tubulin to prevent neutrophil migration into the joint. It is as effective as NSAIDs in relieving acute attacks. It also has a role in prophylactic treatment if Allopurinol is not tolerated.NSAIDs are contra-indicated in heart failure as they can cause fluid retention and congestive cardiac failure. Colchicine is the preferred treatment in patients with heart failure or those who are intolerant of NSAIDs.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      45.6
      Seconds
  • Question 15 - In a 7-year-old child with chickenpox, which of the following would you advise...

    Correct

    • In a 7-year-old child with chickenpox, which of the following would you advise the mother NOT to do?

      Your Answer: Give ibuprofen for the fever

      Explanation:

      Chickenpox (varicella zoster) is a highly contagious airborne disease and has an incubation period of between 7-21 days. It often has a prodromal phase when there is a fever, aches and headaches, dry cough, and sore throat before onset of rash.Some recognized complications of chickenpox are:OrchitisHepatitisPneumoniaEncephalitisInfected spotsOtitis mediaMyocarditisGlomerulonephritisAppendicitisPancreatitisTreatment is symptomatic and includes using paracetamol to manage fever. There is a link between use of ibuprofen in patients with chicken-pox and necrotizing fasciitis so Ibuprofen should NOT be used. An emollient and antihistamine can be used to ease the itchy rash and oral hydration is encouraged.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      17.3
      Seconds
  • Question 16 - The Meissner’s plexus acts as the main control for gastrointestinal secretion and local...

    Correct

    • The Meissner’s plexus acts as the main control for gastrointestinal secretion and local blood flow within the gut.The Meissner’s plexus lies in which layer of the gut wall?

      Your Answer: Submucosa

      Explanation:

      The Meissner’s plexus (submucosal plexus), an enteric nervous plexus, acts as the main control for gastrointestinal secretion and local blood flow within the gut.It is located in the submucosal layer on the inner surface of the muscularis externa.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      20.9
      Seconds
  • Question 17 - Which of the following problems is associated with Helicobacter pylori infection? ...

    Correct

    • Which of the following problems is associated with Helicobacter pylori infection?

      Your Answer: Gastric malignancy

      Explanation:

      Helicobacter pylori is a ubiquitous organism that is present in about 50% of the global population. Chronic infection with H pylori causes atrophic and even metaplastic changes in the stomach, and it has a known association with peptic ulcer disease. The most common route of H pylori infection is either oral-to-oral or faecal-to-oral contact.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      5.3
      Seconds
  • Question 18 - The following are all examples of type III hypersensitivity EXCEPT for: ...

    Incorrect

    • The following are all examples of type III hypersensitivity EXCEPT for:

      Your Answer: Extrinsic allergic alveolitis

      Correct Answer: Goodpasture's syndrome

      Explanation:

      Examples of type III reactions include:Extrinsic allergic alveolitisSystemic lupus erythematosus (SLE)Post-streptococcal glomerulonephritisReactive arthritisRheumatoid arthritis

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      18.5
      Seconds
  • Question 19 - Which of the following best describes pathogenicity: ...

    Incorrect

    • Which of the following best describes pathogenicity:

      Your Answer: The ability to infect the body's own immune cells

      Correct Answer: The ability to cause disease

      Explanation:

      Pathogenicity is the ability to cause disease.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      38
      Seconds
  • Question 20 - A 26-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.Which...

    Incorrect

    • A 26-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.Which of the following is NOT an action of the gluteus maximus muscle? Select ONE answer only.

      Your Answer: Hip extension

      Correct Answer: Hip abduction

      Explanation:

      Gluteus maximus is the main extensor muscle of the hip and assists with lateral rotation of the thigh at the hip joint. It also acts as a hip adductor, steadies the thigh, and assists in raising the trunk from a flexed position.Gluteus maximus is innervated by the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      29.7
      Seconds
  • Question 21 - A 22-year-old woman comes in with an asthmatic flare. Salbutamol is her only regular...

    Incorrect

    • A 22-year-old woman comes in with an asthmatic flare. Salbutamol is her only regular medication.What is the dosage per inhalation of a standard metered dose salbutamol inhaler?

      Your Answer: 200 micrograms

      Correct Answer: 100 micrograms

      Explanation:

      The dose of a conventional metered dose inhaler is 100 micrograms per metered inhalation.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      25.4
      Seconds
  • Question 22 - A 18 year old with known asthma presents himself to ED with acute...

    Correct

    • A 18 year old with known asthma presents himself to ED with acute breathlessness and wheeze for the past 20 minutes. On examination he is tachypneic and tachycardic. His oxygen saturations are 96% on air. What is the first line treatment for acute asthma:

      Your Answer: Salbutamol

      Explanation:

      High-dose inhaled short-acting beta2-agonists are the first line treatment for acute asthma(salbutamol or terbutaline). Oxygen should only been given to hypoxaemic patients (to maintain oxygen saturations of 94 – 98%). A pressurised metered dose inhaler with spacer device is preferred in patients with moderate to severe asthma (4 puffs initially, followed by 2 puffs every 2 minutes according to response, up to 10 puffs, whole process repeated every 10 – 20 minutes if necessary). The oxygen-driven nebuliser route is recommended for patients with life-threatening features or poorly responsive severe asthma (salbutamol 5 mg at 15 – 30 minute intervals). Continuous nebulisation should be considered in patients with severe acute asthma that is poorly responsive to initial bolus dose (salbutamol at 5 – 10 mg/hour) The intravenous route should be reserved for those in whom inhaled therapy cannot be used reliably.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      16.7
      Seconds
  • Question 23 - 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: Enterotoxigenic Escherichia coli

      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
      24.4
      Seconds
  • Question 24 - Regarding Helicobacter pylori, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding Helicobacter pylori, which of the following statements is INCORRECT:

      Your Answer: It expresses urease.

      Correct Answer: It is found as part of normal colonic flora.

      Explanation:

      Helicobacter pyloriis a Gram-negative, helix shaped (curved rod), microaerophilic bacterium. It typically has 4-6 lophotrichous flagellae and is therefore highly motile. It has an outer membrane consisting of phospholipids and lipopolysaccharide.Helicobacter pyloriIs found in the upper gastrointestinal tract of approximately 50% of the population.Colonization withHelicobacter pyloriconfers a 10-20% lifetime risk of developing peptic ulcers and a 1-2% lifetime risk of developing gastric cancer.There is a strong association between mucosa-associated lymphoid tissue (MALT) lymphoma andHelicobacter pyloricolonization.The most reliable method for testing for colonization withHelicobacter pyloriis by biopsy during endoscopy and histological examination.Typically eradication requires a 14-day course of triple therapy with amoxicillin, clarithromycin and a proton pump inhibitor. Metronidazole is also often used as an alternative antibiotic in a triple therapy regime.Serum antibody levels fall slowly and therefore cannot be used to accurately assess eradication. Either of the 13C-urea breath test or the stool antigen test are viable options for assessing successful eradication.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      7.6
      Seconds
  • Question 25 - A 60-year-old man with insulin-controlled diabetes mellitus asks you about how his ability...

    Correct

    • A 60-year-old man with insulin-controlled diabetes mellitus asks you about how his ability to drive is affected. He owns a car as well as a motorcycle.Which of the following statements about driving with diabetes under insulin control is correct?

      Your Answer: He must monitor his blood glucose levels every 2 hours whilst driving

      Explanation:

      The DVLA sends a detailed information sheet about their licence and driving to all drivers with diabetes mellitus. The primary danger of driving while diabetic is hypoglycaemia.The DVLA must be notified of the following diabetic patients:All of the drivers are on insulin. (Licenses are being reviewed more frequently.)Those who are at high risk of hypoglycaemia and have had more than one episode of severe hypoglycaemia in the previous year. (Severe hypoglycaemia is defined as requiring the assistance of another person to manage.)Those who are unaware of their hypoglycaemiaAnyone who has ever been in a car accident due to hypoglycaemiaAnyone with diabetic retinopathy who needs laser treatment (to both eyes or to a second eye if sight only in one eye)Patients with diabetes complications that impair their ability to drive.To drive, drivers with insulin-treated diabetes must meet the following requirements:They need to be aware of hypoglycaemia.They must not have had more than one episode of hypoglycaemia in the previous 12 months that necessitated the assistance of another person.They must check their blood glucose levels no later than 2 hours before the first journey.While driving, they must check their blood glucose levels every two hours.The visual acuity and visual field standards must be met.Any significant changes in their condition must be reported to the DVLA. Furthermore, on days when they are not driving, group 2 licence holders must test their blood glucose twice daily using a metre that can store three months’ worth of readings.In addition to this advice, the DVLA also offers the following advice to diabetic patients:When taking tablets that have the potential to cause hypoglycaemia (such as sulfonylureas and glinides), monitoring may be necessary if there has been more than one episode of severe hypoglycaemia.Drivers must show good control and be able to recognise hypoglycaemia.Verify that your vision meets the required standard.If a patient feels hypoglycaemic or has a blood glucose level of less than 4.0 mmol/L, they should not drive. Driving should not be resumed until blood glucose levels have returned to normal, which should take 45 minutes.If there are any warning signs, patients should carry rapidly absorbed sugar in their vehicle and stop, turn off the ignition, and eat it.If resuscitation is required, a card stating which medications they are taking should be carried.If hypoglycaemia causes an accident, a diabetic driver may be charged with driving under the influence of drugs.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      119.4
      Seconds
  • Question 26 - A 21 year old student presents to the emergency room with severe acute...

    Correct

    • A 21 year old student presents to the emergency room with severe acute asthma. Salbutamol and ipratropium bromide nebuliser are prescribed. The most appropriate dose of salbutamol that should be prescribed initially for this patient is which of the following?

      Your Answer: 5 mg every 15 - 30 minutes

      Explanation:

      The first line treatment for acute asthma is high-dose inhaled short-acting beta2-agonists like salbutamol or terbutaline. Oxygen use should be reserved for hypoxemic patients in order to maintain oxygen saturations of 94 – 98%. In patients with moderate to severe asthma, a pressurised metered dose inhaler with spacer device is preferred (4 puffs initially, followed by 2 puffs every 2 minutes according to response, up to 10 puffs, whole process repeated every 10 – 20 minutes if necessary). For patients with life-threatening features or poorly responsive severe asthma, the oxygen-driven nebuliser route is recommended (salbutamol 5 mg at 15 – 30 minute intervals). In patients with severe acute asthma that is poorly responsive to initial bolus dose, continuous nebulisation should be considered (salbutamol at 5 – 10 mg/hour). For those in whom inhaled therapy cannot be used reliably, the intravenous route is usually reserved.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      19.3
      Seconds
  • Question 27 - Regarding Hodgkin lymphoma, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding Hodgkin lymphoma, which of the following statements is CORRECT:

      Your Answer: Most patients present with painful generalised lymphadenopathy.

      Correct Answer: Some patients may complain alcohol-induced nodal pain and pruritus

      Explanation:

      Lymphomas are a group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and other lymphoid tissue and cause the characteristic clinical feature of lymphadenopathy. The major subdivision of lymphomas is into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) and this is based on the histological presence of Reed-Sternberg cells present in HL. Hodgkin lymphoma can present at any age but is rare in children and has a peak incidence in young adults. There is an almost 2 : 1 male predominance. Most patients present with painless, asymmetrical, firm and discrete enlargement of superficial lymph nodes. Cervical nodes are involved in 60-70% of cases, axillary nodes in 10-15% and inguinal nodes in 6-12%. Modest splenomegaly occurs during the course of the disease in 50% of patients; the liver may also be enlarged. Bone marrow failure involvement is unusual in early disease. The prognosis depends on age, stage and histology, but overall approximately 85% of patients are cured. Alcohol‐induced pain and pruritus are two well‐known but rare symptoms in HL.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      16.2
      Seconds
  • Question 28 - A 30-year-old man present to the ED with abdominal pain, nausea and vomiting....

    Correct

    • A 30-year-old man present to the ED with abdominal pain, nausea and vomiting. It has been present for the past two days.Which of the following statements regarding diarrhoea and vomiting is true?

      Your Answer: E.Coli can cause diarrhoea and renal failure

      Explanation:

      Escherichia coli strain 0157 causes enterohaemorrhagic diarrhoea and can lead to renal failure, haemolytic anaemia and thrombocytopenia.Norwalk virus is an RNA virus.Although transmission of rotavirus is primarily through the faeco-oral route, airborne spread has been seen in some cases.Cryptosporidium are protozoa with acid fast walls and are resistant to both chlorine treatment and conventional filtering methods. There is no therapy effective in treating cryptosporidium diarrhoea as the protozoa is not susceptible to antibiotics.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      51.9
      Seconds
  • Question 29 - Regarding aciclovir, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer: Aciclovir acts to inhibit viral DNA synthesis.

      Correct Answer: Aciclovir eradicates herpes simplex virus from the body.

      Explanation:

      Aciclovir is active against herpesviruses but does not eradicate latent virus.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      30.5
      Seconds
  • Question 30 - A 20-year-old male receives a small cut over his hand while climbing a...

    Correct

    • A 20-year-old male receives a small cut over his hand while climbing a fence causing it to bleed. Upon applying pressure for a few minutes, the bleeding stops. Which one of the following physiological components of the blood is responsible for the primary haemostasis reaction, such as in this case?

      Your Answer: Platelet plug formation

      Explanation:

      Haemostasis is your body’s defence against an injury that causes bleeding. It stops bleeding in three main steps: 1) Primary haemostasis – formation of a weak platelet plug- The primary reaction of the body is to cause local vasoconstriction at the site of injury and decrease blood flow to the affected area- the release of cytokines and inflammatory markers lead to adhesion of platelets and aggregation at the site of injury forming a platelet plug- the injured vessel wall has exposed subendothelial collagen that releases von Willebrand factor Any damage to the vessel wall causes the release of the Von Willebrand factor, which is necessary for platelet adhesion. Tissue Thromboplastin is also released, which activates the coagulation pathway, a component of secondary haemostasis. The coagulation cascade ultimately results in the conversion of fibrinogen to fibrin.2) Secondary haemostasis 3) Fibrinolysis

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      24.5
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (5/9) 56%
Specific Pathogen Groups (3/4) 75%
Pathogens (2/4) 50%
Endocrine (1/1) 100%
Physiology (4/4) 100%
Evidence Based Medicine (0/1) 0%
Anatomy (1/4) 25%
Cranial Nerve Lesions (1/2) 50%
Cardiovascular Pharmacology (2/2) 100%
Pharmacology (6/8) 75%
Renal Physiology (1/1) 100%
Basic Cellular Physiology (1/1) 100%
Head And Neck (0/1) 0%
Haematology (1/2) 50%
Pathology (1/3) 33%
Musculoskeletal Pharmacology (1/1) 100%
Gastrointestinal Physiology (1/1) 100%
Immune Responses (0/1) 0%
Principles (0/1) 0%
Lower Limb (0/1) 0%
Respiratory Pharmacology (0/1) 0%
Respiratory (2/2) 100%
Endocrine Pharmacology (1/1) 100%
Infections (0/1) 0%
Passmed