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  • Question 1 - A 22-year-old woman is brought in by ambulance from her GP surgery with...

    Incorrect

    • A 22-year-old woman is brought in by ambulance from her GP surgery with suspected meningitis. She has been given a dose of benzylpenicillin already.
      What is the mechanism of action of benzylpenicillin? Select ONE answer only.

      Your Answer:

      Correct Answer: Inhibition of cell wall synthesis

      Explanation:

      Penicillins and the other ß-lactam antibiotics are bactericidal. They produce their antimicrobial action by preventing cross-linkage between the linear peptidoglycan polymer chains that make up the bacterial cell wall. They, therefore, inhibit cell wall synthesis.
      An overview of the different mechanisms of action of the various types of antimicrobial agents is shown below:
      Mechanism of action
      Examples
      Inhibition of cell wall synthesis
      Penicillins
      Cephalosporins
      Vancomycin
      Disruption of cell membrane function
      Polymyxins
      Nystatin
      Amphotericin B
      Inhibition of protein synthesis
      Macrolides
      Aminoglycosides
      Tetracyclines
      Chloramphenicol
      Inhibition of nucleic acid synthesis
      Quinolones
      Trimethoprim
      5-nitroimidazoles
      Rifampicin
      Anti-metabolic activity
      Sulfonamides
      Isoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 2 - You examine a 34-year-old lady with symptoms that are consistent with acute sinusitis. You're...

    Incorrect

    • You examine a 34-year-old lady with symptoms that are consistent with acute sinusitis. You're thinking about giving her doxycycline for treatment.

      What is doxycycline's mechanism of action?

      Your Answer:

      Correct Answer: Inhibition of protein synthesis

      Explanation:

      Doxycycline and other tetracycline antibiotics attach to the 30S subunit of the bacterial ribosome, preventing aminoacyl-tRNA binding and so protein synthesis beginning.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 3 - A 24-year-old athlete drinks a 500 ml hypertonic sports drink before an endurance...

    Incorrect

    • A 24-year-old athlete drinks a 500 ml hypertonic sports drink before an endurance event he participates in.

      Which of the following effects will this cause?

      Your Answer:

      Correct Answer: The interstitial fluid becomes more concentrated

      Explanation:

      Osmosis is the passive movement of water across a semipermeable membrane from a region of low solute concentration to a region of higher solute concentration.
      When hypertonic fluid is ingested:
      The plasma becomes CONCENTRATED.

      The cells lose water and shrink
      The intracellular fluid becomes more concentrated.
      Water and ions move freely from the plasma into the interstitial fluid and the interstitial fluid becomes more concentrated.
      The increased osmotic potential draws water out of the cells.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
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  • Question 4 - The ventilation over perfusion ratio is highest at the apex of the lung....

    Incorrect

    • The ventilation over perfusion ratio is highest at the apex of the lung. What is the approximate V/Q ratio at this area?

      Your Answer:

      Correct Answer: 3.3

      Explanation:

      The ventilation/perfusion ratio (V/Q ratio) is a ratio used to assess the efficiency and adequacy of the matching ventilation and perfusion. The ideal V/Q ratio is 1.

      Any mismatch between ventilation and perfusion will be evident in the V/Q ratio. If perfusion is normal but ventilation is reduced, the V/Q ratio will be less than 1, whereas if ventilation is normal, but perfusion is reduced, the V/Q ratio will be greater than 1.

      If the alveoli were ventilated but not perfused at all, then the V/Q ratio would be infinity. The V/Q ratio is also affected by location. The various areas of the lungs have a different V/Q ratio since ventilation and perfusion increase from the apex to the base of the lungs. The apex of the lungs has a V/Q ratio of approximately 3.3.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
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  • Question 5 - A 42-year-old patient with worsening epigastric pain has been referred to you by...

    Incorrect

    • A 42-year-old patient with worsening epigastric pain has been referred to you by a GP. The patient has been taking omeprazole for a month, but her symptoms are getting worse.

      Which of the following is NOT a well-known side effect of proton pump inhibitor treatment?

      Your Answer:

      Correct Answer: Pelvic fracture

      Explanation:

      Proton pump inhibitors (PPIs) have a variety of side effects, including:
      Vomiting and nausea
      Pain in the abdomen
      Flatulence
      Diarrhoea
      Constipation
      Headache

      PPIs have been linked to a significant increase in the risk of focal tachyarrhythmias (link is external).
      Low serum magnesium and sodium levels have been linked to long-term use of PPIs, according to the US Food and Drug Administration (link is external).

      Long-term PPI use has also been linked to an increased risk of fracture, according to epidemiological evidence (link is external). Observational studies have discovered a slight link between hip, wrist, and spine fractures. However, there is no link between the two and an increased risk of pelvic fracture. For this reason, the MHRA recommends that patients at risk of osteoporosis who take PPIs maintain an adequate calcium and vitamin D intake.

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
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  • Question 6 - If the afferent arteriole's diameter is smaller than the efferent arteriole's diameter in...

    Incorrect

    • If the afferent arteriole's diameter is smaller than the efferent arteriole's diameter in the glomerulus:

      Your Answer:

      Correct Answer: The net filtration pressure will decrease

      Explanation:

      The relative resistance of the afferent and efferent arterioles substantially influences glomerular capillary hydrostatic pressure and consequently GFR. Filtration is forced through the filtration barrier due to high pressure in the glomerular capillaries. Afferent arteriolar constriction lowers this pressure while efferent arteriolar constriction raises it.

    • This question is part of the following fields:

      • Physiology
      • Renal
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  • Question 7 - A 59-year-old otherwise well woman presents with a history of polydipsia and...

    Incorrect

    • A 59-year-old otherwise well woman presents with a history of polydipsia and polyuria. There is a past history of kidney stones, and blood tests done reveal the following:

      Na: 147 mmol/L (135-147 mmol/L)
      K: 4.0 mmol/L (3.5-5.5 mmol/L)
      Urea: 7.3 mmol/L (2.0-6.6 mmol/L)
      Creatinine: 126 mmol/L (75-125 mmol/L)
      Fasting blood glucose: 5.0 mmol/L (3.4-5.5 mmol/L)
      Corrected calcium: 3.21 mmol/L (2.05-2.60 mmol/L)
      Phosphate: 0.70 mmol/L (0.8-1.4 mmol/L)
      Parathyroid hormone: 189 ng/L (10-60 ng/L)

      The most likely diagnosis is?

      Your Answer:

      Correct Answer: Primary hyperparathyroidism

      Explanation:

      ​Primary hyperparathyroidism the commonest cause of hypercalcaemia. It is commonest in women aged 50 to 60.
      The commonest cause of primary hyperparathyroidism is a solitary adenoma of the parathyroid gland (approximately 85% of cases).

      Primary hyperparathyroidism may present with features of hypercalcaemia such as polyuria, polydipsia, renal stones, bone and joint pain, constipation, and psychiatric disorders.

      In primary Hyperparathyroidism:
      PTH is elevated
      Calcium is elevated
      Phosphate is lowered

      In secondary Hyperparathyroidism:
      PTH is elevated
      Calcium is low or low-normal
      Phosphate is raised in CRF

      In tertiary Hyperparathyroidism:
      PTH is elevated
      Calcium is elevated
      Phosphate is lowered in CRF

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
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  • Question 8 - Which of the following is NOT a typical clinical feature of hypoglycaemia: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Polyuria

      Explanation:

      Clinical features of hypoglycaemia:
      Autonomic  symptoms: Sweating, feeling hot, anxiety/agitation, palpitations, shaking, paraesthesia, dizziness
      Neuroglycopaenic symptoms: Weakness, blurred vision, difficulty speaking, poor concentration, poor coordination, drowsiness, confusion, seizures, coma
      Other symptoms: Nausea, fatigue, hunger

    • This question is part of the following fields:

      • Endocrine
      • Physiology
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  • Question 9 - Regarding Clostridium tetani, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Metronidazole is usually the antibiotic of choice for tetanus infection.

      Explanation:

      Clostridium tetani infection is predominantly derived from animal faeces and soil.  Clostridium tetani has exotoxin-mediated effects, predominantly by tetanospasmin which inhibits the release of GABA at the presynaptic membrane throughout the central and peripheral nervous system. Metronidazole has overtaken penicillin as the antibiotic of choice for treatment of tetanus (together with surgical debridement, tetanus toxoid immunisation, and human tetanus immunoglobulin).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 10 - In which of the following cases is intravenous phenytoin contraindicated? ...

    Incorrect

    • In which of the following cases is intravenous phenytoin contraindicated?

      Your Answer:

      Correct Answer: Second degree heart block

      Explanation:

      Phenytoin Contraindications include:

      Hypersensitivity
      Sinus bradycardia
      Sinoatrial block
      Second and third degree A-V block
      Adams-Stokes syndrome
      Concurrent use with delavirdine
      History of prior acute hepatotoxicity attributable to phenytoin

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 11 - A 72-year-old woman presents to your clinic with worsening oedema. She is a...

    Incorrect

    • A 72-year-old woman presents to your clinic with worsening oedema. She is a known case of ischaemic heart disease and heart failure.

      You decide to add a loop diuretic to her current drug regime to control the oedema.

      Of the following, what is a contraindication to using a loop diuretic?

      Your Answer:

      Correct Answer: Anuria

      Explanation:

      Loop diuretics are drugs used to manage and treat fluid overload associated with CHF, liver cirrhosis, and renal disease. The drugs commonly used are:
      Furosemide
      Bumetanide
      Torsemide
      Ethacrynic Acid

      Loop diuretics inhibit the Na-K-Cl pump in the ascending loop of Henle, resulting in salt-water excretion. This relieves congestion and reduces oedema.

      The contra-indications to the use of loop diuretics are:
      1. Anuria
      2. Comatose and precomatose states associated with liver cirrhosis
      3. Renal failure due to nephrotoxic or hepatotoxic drugs
      4. Severe hypokalaemia
      5. Severe hyponatremia
      6. History of hypersensitivity to furosemide, bumetanide, or torsemide (or sulphonamides)

      The following conditions or states are not contraindications, but loop diuretics needs to be used cautiously in these conditions:
      1. Diabetes (but hyperglycaemia less likely than with thiazides)
      2. Gout
      3. Hypotension (correct before initiation of treatment)
      4. Hypovolaemia (Correct before initiation of treatment)

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 12 - Which of the following is the most abundant peripheral blood leucocyte: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Neutrophils

      Explanation:

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

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
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  • Question 13 - The movement of molecules across the cell membrane relies greatly on active transport.

    Which of...

    Incorrect

    • The movement of molecules across the cell membrane relies greatly on active transport.

      Which of the following statements about active transport is correct?

      Your Answer:

      Correct Answer: Active transport occurs in glucose absorption from the gut

      Explanation:

      The movement of a material against a concentration gradient, i.e. from a low to a high concentration, is known as active transport. Primary active transport is defined as active transport that involves the use of chemical energy, such as adenosine triphosphate (ATP). Secondary active transport occurs when an electrochemical gradient is used.

      The sodium-potassium pump, calcium ATPase pump, and proton pump are all key active transport systems that use ATP. An electrochemical gradient is used by the sodium-calcium co-transporter, which is an example of secondary active transport.

      The sodium-dependent hexose transporter SGLUT-1 transports glucose and galactose into enterocytes. Secondary active transport is exemplified here.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
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  • Question 14 - By which of the following is mean arterial pressure (MAP) primarily determined? ...

    Incorrect

    • By which of the following is mean arterial pressure (MAP) primarily determined?

      Your Answer:

      Correct Answer: Total peripheral resistance and cardiac output

      Explanation:

      Mean arterial pressure (MAP) = Cardiac output (CO) x Total peripheral resistance (TPR).

      Cardiac output is dependent on the central venous pressure (CVP). CVP, in turn, is highly dependent on the blood volume.
      Any alterations of any of these variables will likely change MAP.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 15 - A 4-year-old child has been convulsing for 20 minutes. She has received two...

    Incorrect

    • A 4-year-old child has been convulsing for 20 minutes. She has received two doses of lorazepam. She takes phenytoin for maintenance therapy, and you draw up a phenobarbitone infusion.
      What dose of phenobarbitone is advised in the treatment of the convulsing child that reaches that stage of the APLS algorithm? Select ONE answer only.

      Your Answer:

      Correct Answer: 20 mg/kg over 30-60 minutes

      Explanation:

      If a convulsing child reaches step 3 of the APLS algorithm, then a phenytoin infusion should be set up at 20 mg/kg over 20 minutes. If they are already taken phenytoin as maintenance therapy, then a phenobarbitone infusion should be set up at 20 mg/kg over 30-60 minutes.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
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  • Question 16 - A 29-year-old man is diagnosed with a severe case of asthma.

    In the treatment...

    Incorrect

    • A 29-year-old man is diagnosed with a severe case of asthma.

      In the treatment of acute asthma in adults, which of the following is NOT recommended?

      Your Answer:

      Correct Answer: Nebulised magnesium

      Explanation:

      There is no evidence to support the use of nebulized magnesium sulphate in the treatment of adults at this time.

      In adults with acute asthma, the following medication dosages are recommended:
      By using an oxygen-driven nebuliser, you can get 5 milligrams of salbutamol.
      500 mcg ipratropium bromide in an oxygen-driven nebuliser
      Oral prednisolone 40-50 mg
      100 mg hydrocortisone intravenous
      1.2-2 g magnesium sulphate IV over 20 minutes
      When inhaled treatment is ineffective, intravenous salbutamol (250 mcg IV slowly) may be explored (e.g. a patient receiving bag-mask ventilation).

      Following senior counsel, current ALS recommendations propose that IV aminophylline be explored in severe or life-threatening asthma. If utilized, a loading dose of 5 mg/kg should be administered over 20 minutes, then a 500-700 mcg/kg/hour infusion should be given. To avoid toxicity, serum theophylline levels should be kept below 20 mcg/ml.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
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  • Question 17 - Which of the following is an ECG change typically associated with hyperkalaemia: ...

    Incorrect

    • Which of the following is an ECG change typically associated with hyperkalaemia:

      Your Answer:

      Correct Answer: Wide QRS complex

      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 abnormalities
      K+>6.5 mmol/l – P waves widen and flatten, PR segment lengthens, P waves eventually disappear
      K+>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
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  • Question 18 - All of the following statements are considered true regarding randomized control trials, except:...

    Incorrect

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

      Your Answer:

      Correct Answer: They can eliminate the need for further studies

      Explanation:

      Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess previous research studies to derive conclusions about that body of research. Outcomes from a meta-analysis may include a more precise estimate of the effect of treatment or risk factor for disease, or other outcomes, than any individual study contributing to the pooled analysis. The examination of variability or heterogeneity in study results is also a critical outcome.
      The benefits of meta-analysis include a consolidated and quantitative review of a large, and often complex, sometimes apparently conflicting, body of literature. The specification of the outcome and hypotheses that are tested is critical to the conduct of meta-analyses, as is a sensitive literature search.

      Important medical questions are typically studied more than once, often by different research teams in different locations. In many instances, the results of these multiple small studies of an issue are diverse and conflicting, which makes the clinical decision-making difficult. The need to arrive at decisions affecting clinical practise fostered the momentum toward evidence-based medicine. Evidence-based medicine may be defined as the systematic, quantitative, preferentially experimental approach to obtaining and using medical information. Therefore, meta-analysis, a statistical procedure that integrates the results of several independent studies, plays a central role in evidence-based medicine.

    • This question is part of the following fields:

      • Evidence Based Medicine
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  • Question 19 - Which of the following terms describes the proportion of individuals with a negative...

    Incorrect

    • Which of the following terms describes the proportion of individuals with a negative test result who actually do not have a disease:

      Your Answer:

      Correct Answer: Negative predictive value

      Explanation:

      Negative predictive value (NPV) is the proportion of individuals with a negative test result who do not have the disease.
      NPV = d/(c+d)

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
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  • Question 20 - Regarding forest plots, which of the following is the purpose of this graph?...

    Incorrect

    • Regarding forest plots, which of the following is the purpose of this graph?

      Your Answer:

      Correct Answer: To graphically display the relative strength of multiple studies attempting to answer the same question

      Explanation:

      The results of meta-analysis are often displayed graphically in a forest plot. A properly constructed forest plot is the most effective way to graphically display the relative strength of multiple studies attempting to answer the same question. A typical meta-analysis consists of three main objectives that include estimation of effect sizes from individual studies and a pooled summary estimate with their confidence intervals (CIs), heterogeneity among the studies, and any publication bias. The forest plot illustrates the first two of these objectives. Forest plots visualize the effect measure and CI of individual studies, which provide the raw data for the meta-analysis, as well the pooled-effect measure and CI. The individual studies also can be grouped in the forest plot by some of their characteristics for ease of interpretation such as by study size or year of publication. When comparing the outcomes between an intervention and a control group, dichotomous outcome variables are expressed as ratios (i.e. odds ratios, ORs or risk ratios, RRs), while for continuous outcomes, a weighted mean difference is reported.

    • This question is part of the following fields:

      • Evidence Based Medicine
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  • Question 21 - The muscles of the soft palate (other than the tensor veli palatini) are...

    Incorrect

    • The muscles of the soft palate (other than the tensor veli palatini) are innervated by which of the following nerves:

      Your Answer:

      Correct Answer: Vagus nerve

      Explanation:

      All of the muscles of the soft palate are innervated by the vagus nerve (from the pharyngeal plexus), except for the tensor veli palatini, which is innervated by a branch of the mandibular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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  • Question 22 - A 30-year old male is taken to the emergency room after suffering a...

    Incorrect

    • A 30-year old male is taken to the emergency room after suffering a blunt trauma to the abdomen. He is complaining of severe abdominal pain, however all his other vital signs remain stable. A FAST scan is performed to assess for hemoperitoneum.

      If hemoperitoneum is present, it is most likely to be observed in which of the following areas?

      Your Answer:

      Correct Answer: Liver

      Explanation:

      The Focused Assessment with Sonography in Trauma (FAST) is an ultrasound protocol developed to assess for hemoperitoneum and hemopericardium. Numerous studies have demonstrated sensitivities between 85% to 96% and specificities exceeding 98%.

      The FAST exam evaluates four regions for pathologic fluid: (1) the right upper quadrant, (2) the subxiphoid (or subcostal) view, (3) the left upper quadrant, and (4) the suprapubic region.

      The right upper quadrant (RUQ) visualizes the hepatorenal recess, also known as Morrison’s pouch, the right paracolic gutter, the hepato-diaphragmatic area, and the caudal edge of the left liver lobe. The probe is positioned in the sagittal orientation along the patient’s flank at the level of the 8 to 11 rib spaces. The hand is placed against the bed to ensure visualization of the retroperitoneal kidney. The RUQ view is the most likely to detect free fluid with an overall sensitivity of 66%. Recent retrospective evidence suggests the area along the caudal edge of the left lobe of the liver has the highest sensitivity, exceeding 93%.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
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  • Question 23 - The extensor digitorum longus is supplied by which nerve? ...

    Incorrect

    • The extensor digitorum longus is supplied by which nerve?

      Your Answer:

      Correct Answer: Deep peroneal nerve

      Explanation:

      The extensor digitorum longus is innervated by the deep fibular nerve (L5, S1), a branch of the common fibular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 24 - A 10-year-old girl presents with polyuria, polydipsia, and stomach pain. She has a...

    Incorrect

    • A 10-year-old girl presents with polyuria, polydipsia, and stomach pain. She has a history of type I diabetes mellitus. On blood gas analysis, she has metabolic acidosis. Diabetic ketoacidosis (DKA) is diagnosed, and therapy is initiated. She becomes increasingly confused when intravenous fluids and insulin are administered.

      Which electrolyte imbalance is the MOST likely reason of the increased confusion

      Your Answer:

      Correct Answer: Hyponatraemia

      Explanation:

      Because of the shift of water from the intracellular to the extracellular compartment as a result of hyperglycaemia and increased plasma osmolality, dilutional hyponatraemia is common in diabetic ketoacidosis (DKA).

      If intravenous fluids are not delivered with caution, hyponatraemia might worsen, which can lead to increased degrees of disorientation. Hyponatraemia has also been linked to an increased risk of cerebral oedema, especially if blood glucose levels drop too quickly following treatment.

      Headache, recurrence of vomiting, irritability, Glasgow Coma Scale score, inappropriate heart rate slowing, and rising blood pressure are the most common causes of death in paediatric DKA, and children should be monitored for the symptoms mentioned above. To prevent this from developing,  s low osmolarity normalization, attention to glucose and salt levels, as well as hydration over 48 hours, is necessary. 

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
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  • Question 25 - In adult advanced life support, which of the following best describes the correct...

    Incorrect

    • In adult advanced life support, which of the following best describes the correct administration of adrenaline for a non-shockable rhythm:

      Your Answer:

      Correct Answer: Give 1 mg of adrenaline as soon as intravenous access is achieved and every 3 - 5 minutes thereafter

      Explanation:

      IV adrenaline 1 mg (10 mL of 1:10,000 solution) should be given after 3 shocks and every 3 – 5 minutes/after alternate shocks thereafter.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 26 - A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from...

    Incorrect

    • A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from the steering wheel of his car after falling asleep while driving headlong into an oncoming HGV lorry. Bruising around his sternum was observed, which appears to be the central point of impact.

      Which of the following structures is most likely injured by the blunt force trauma?

      Your Answer:

      Correct Answer: Right ventricle

      Explanation:

      In its typical anatomical orientation, the heart has 5 surfaces formed by different internal divisions of the heart:

      Anterior (or sternocostal) – Right ventricle
      Posterior (or base) – Left atrium
      Inferior (or diaphragmatic) – Left and right ventricles
      Right pulmonary – Right atrium
      Left pulmonary – Left ventricle

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 27 - Which of the following ligaments supports the head of the talus? ...

    Incorrect

    • Which of the following ligaments supports the head of the talus?

      Your Answer:

      Correct Answer: Spring ligament

      Explanation:

      The spring-ligament complex is a significant medial arch stabilizer.

      The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 28 - Following a bee sting, a 12-year old boy was transported to resus with...

    Incorrect

    • Following a bee sting, a 12-year old boy was transported to resus with symptoms and signs of an anaphylactic reaction. You decide to administer adrenaline IM stat.

      What is the recommended dose of intramuscular adrenaline?

      Your Answer:

      Correct Answer: 0.3 mL of 1:1000

      Explanation:

      Anaphylaxis is a type I hypersensitivity reaction that is severe and life-threatening. It is marked by the fast onset of life-threatening airway and/or circulatory issues, which are generally accompanied by skin and mucosal abnormalities. When an antigen attaches to specific IgE immunoglobulins on mast cells, degranulation and the release of inflammatory mediators takes place (e.g. histamine, prostaglandins, and leukotrienes).

      The most important medicine for treating anaphylactic responses is adrenaline. It decreases oedema and reverses peripheral vasodilation as an alpha-adrenergic receptor agonist. Its beta-adrenergic effects widen the bronchial airways, enhance the force of cardiac contraction, and inhibit the release of histamine and leukotriene. The first medicine to be given is adrenaline, and the IM route is optimal for most people.

      In anaphylaxis, age-related dosages of IM adrenaline are:
      150 mcg (0.15 mL of 1:1000) for a child under 6 years
      300 mcg (0.3 mL of 1:1000) for a child aged 6 to 12 years
      500 mcg (0.5 mL of 1:1000) for children aged 12 and above
      500 mcg for adults (0.5 mL of 1:1000)

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
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  • Question 29 -
    A patient with Conn’s syndrome will experience which of the following clinical features?
    ...

    Incorrect


    • A patient with Conn’s syndrome will experience which of the following clinical features?

      Your Answer:

      Correct Answer: Hypernatraemia

      Explanation:

      Conditions to consider in the differential diagnosis of primary aldosteronism or Conn’s syndrome include hypertension, metabolic alkalosis, hypokalaemia, hypernatremia, and low renin levels.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
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  • Question 30 - What is the approximate lifespan of the mature erythrocyte: ...

    Incorrect

    • What is the approximate lifespan of the mature erythrocyte:

      Your Answer:

      Correct Answer: 120 days

      Explanation:

      Erythrocytes have a normal lifespan of about 120 days. Mature erythrocytes are biconcave discs with no nucleus, ribosomes or mitochondria but with the ability to generate energy as ATP by the anaerobic glycolytic pathway. The red cell membrane consists of a bipolar lipid layer with a membrane skeleton of penetrating and integral proteins anchoring carbohydrate surface antigens. The shape and flexibility of red cells allows them to deform easily and pass through capillaries.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
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