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Date Completed: 15/11/2023
Page 1 of 18
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Management of Tachyarrhythmias
What is the initial dose of adenosine recommended for management of a regular narrow-complex tachycardia:
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Theophylline: Pharmacology
Regarding theophylline, which of the following statements is INCORRECT:
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Definition of P Value
P= 0.05 means that the probability of an observed difference between two groups having happened by chance is:
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Pathogenesis of Tetanus
Regarding Clostridium tetani, which of the following statements is CORRECT:
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Calculation of Relative Risk Reduction
A randomised controlled trial (RCT) is carried out to study the effects of a new anticoagulant, Anticlot, on stroke incidence in patients w
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Ketamine: Mechanism of Action
Your consultant decides to use ketamine for a patient requiring procedural sedation in the Emergency Department. At what receptor does ketam
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Cutaneous Innervation of the Lower Limb
The skin over the webspace between the 1st and 2nd toe is supplied by which of the following nerves:
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Production and Function of Vitamin D
Regarding vitamin D, which of the following statements is CORRECT:
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Attachments of the Pectoralis Major Muscle
A 67 year old man is brought into the ED following a road traffic collision. You are performing a secondary survey. You note he is tender ov
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Traumatic Cerebrospinal Fluid Leak
A 31 year old male presents to ED with a head injury. Rhinorrhoea will most likely result from fracture of which of the following bones:
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Anatomy of the Glossopharyngeal Nerve
Regarding the glossopharyngeal nerve, which of the following statements is CORRECT:
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Antihistamines: Indications
Which of the following is NOT an indication for a H1 receptor antihistamine:
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Function of the Mandibular Nerve
The mandibular division of the trigeminal nerve supplies general sensation to all of the following regions EXCEPT for the:
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Articulations of the Tarsal Bones
The cuneiform bones articulate with which of the following bones:
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Clinical Effects of Vagus Nerve Leison
Which of the following clinical features is NOT typical for a vagal nerve palsy:
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Function of the Pituitary Gland
Which of the following hormones originates in the anterior pituitary:
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Cutaneous Innervation of the Face
The area of skin over the anterior temple above the zygomatic arch is primarily supplied by which of the following nerves:
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Cutaneous Innervation of the Upper Limb
A 32 year old electrician presents to the ED after sustaining a laceration to the forearm. On examination of the hand you note loss of sensa
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Transport across a Cell Membrane
Which of the following is characterised by transporting a substance against its electrochemical gradient, powered by moving another substanc
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Antipsychotics: Side Effects
Extrapyramidal side effects occur in patients taking antipsychotic drugs because they:
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Attachments of the Latissimus Dorsi Muscle
A 39 year old man is brought to ED having sustained a stab wound to the posterolateral trunk at the level of the T7 vertebra. Which of the f
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Megaloblastic Anaemia
Regarding folate requirements, which of the following statements is CORRECT:
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Innervation of the Sartorius Muscle
A 27 year old footballer presents with pain on flexion and lateral rotation of the hip and flexion of the knee. You suspect a sartorius musc
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Ciprofloxacin: Side Effects
A 62 year old marathon runner presents to ED with Achilles tendon rupture. He has recently started a course of antibiotics from his GP. Whic
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Function of the Renin-Angiotensin-Aldosterone System
Which of the following causes increased aldosterone secretion:
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Ligaments of the Vertebral Column
Regarding the ligaments of the spinal column, which of the following statements is CORRECT:
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Clinical Features of Pneumonia
A 71 year old man is diagnosed with community acquired pneumonia. He is confused. He has a BP of 110/70 mmHg, a HR of 120 bpm, a RR of 25 br
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Location of the Temporal Lobe
Which of the following best describes the position of the temporal lobe:
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Increased vs Normal Anion Gap
Which of the following is typically a cause of a normal anion gap metabolic acidosis:
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Complications of Campylobacter Gastroenteritis
A patient presents to ED complaining of a 3 day history of progressive muscle weakness and paraesthesia which started in both feet and appea
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Definition of the Osmolal Gap
Regarding the osmolal gap, which of the following statements is CORRECT:
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Constrictions of the Ureter
A 55 year old woman presents to ED complaining of severe colicky loin to groin pain. Imaging shows renal calculi. At which of the following
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Trimethoprim: Pharmacology
Regarding trimethoprim, which of the following statements is INCORRECT:
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Function of the Fibularis Tertius Muscle
The fibularis tertius muscle acts to produce which of the following movements:
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Function of the Adrenal Cortex
Selective destruction of the zona glomerulosa of the adrenal cortex would produce deficiency of which of the following hormones:
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Characteristics of Clostridium Difficile
Regarding Clostridium difficile, which of the following statements is CORRECT:
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Types of Data
As part of a quality improvement project you are handing out patient satisfaction questionnaires to patients who have presented with low bac
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Transmission of Salmonella Enterica
Salmonella enterica is primarily transmitted by which of the following routes:
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Boundaries of the Anatomical Snuffbox
A 78 year old woman suffers a destructive injury to the anatomical snuff box region after falling on an outstretched hand. Which of the foll
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Clinical Features of Malaria
A 35 year old Nigerian woman presents to ED with a high fever and rigors. She has recently returned from a trip to visit family in her home
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Phases of the Cardiac Cycle
Regarding the cardiac cycle, which of the following statements is CORRECT:
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Function of the Endothelium
Regarding endothelium derived nitric oxide, which of the following statements is INCORRECT:
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Control of Gastric Emptying
Regarding gastric motility and emptying, which of the following statements is CORRECT:
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Routine Immunisation Schedule
Regarding the UK routine childhood immunisation schedule which of the following vaccines is NOT given at 4 months:
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Management of Tachyarrhythmias
What is the initial dose of amiodarone recommended for treatment of a stable regular broad-complex tachycardia:
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Microstructure of the Cardiac Myocyte
Which of the following structures prevents a direct electrical pathway from the atria to the ventricles:
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Disturbance of Acid-Base Balance
What type of breathing pattern is classically seen in metabolic acidosis:
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Boundaries of the Inguinal Canal
The floor of the inguinal canal is formed primarily by which of the following structures:
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Sodium Nitroprusside: Contraindications
Sodium nitroprusside is contraindicated in which of the following:
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Clinical Effects of Femoral Nerve Injury
A 28 year old man was involved in a motorbike accident where he sustained a crush injury to his pelvis and right leg and damaged a nerve inn
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Clinical Effects of Tibial Nerve Injury
A 54 year old woman presents to ED complaining of pain and swelling behind her knee, and difficulty walking. Imaging shows a large cyst in t
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Haemolytic Anaemia
Which of the following is NOT mainly characterised by intravascular haemolysis:
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Anatomy of the Temporomandibular Joint
Regarding the temporomandibular joint (TMJ), which of the following statements is INCORRECT:
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Characteristics of Dermatophytes
Regarding dermatophytes, which of the following statement is CORRECT:
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Incomplete Lesions of the Spinal Cord
A 29 year old male racing driver has fractured a cervical vertebra. On examination, he has weakness of the right side of his body with upgoi
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Clinical Features of Phaeochromocytoma
Which of the following clinical features would you most expect to see in a patient with a phaeochromocytoma:
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Anatomy of the Spinal Accessory Nerve
Regarding the accessory nerve, which of the following statements is INCORRECT:
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Layers of the Neck Fascia
Regarding the neck fascia, which of the following statements is INCORRECT:
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Regulation of Antidiuretic Hormone
Antidiuretic hormone (ADH) release from the posterior pituitary is directly stimulated by which of the following:
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Thiopental: Side Effects
Which of the following is NOT a typical side effect of thiopental sodium:
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Mechanism of Carbohydrate Digestion
Regarding carbohydrate digestion, which of the following statements is CORRECT:
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Cutaneous Innervation of the Face
The skin of the lower central part of the forehead is primarily supplied by which of the following nerves:
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Anatomy of the Vagus Nerve
Regarding the vagus nerve, which of the following statements is CORRECT:
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Life Cycle of Plasmodium Spp.
Regarding the Plasmodium spp. life cycle, which of the following infects erythrocytes:
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Palpation of the Radial Artery
You are demonstrating a vascular examination on a patient to a group of medical students. Where is the radial artery pulsation best palpated
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Anatomical Location of the Pituitary Gland
A patient presents with headaches and vision loss. Images shows empty sella syndrome. The sella turcica is present in which of the following
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Heparin: Side Effects
Regarding heparin-induced thrombocytopaenia (HIT), which of the following statements is CORRECT:
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Mechanism of Transcapillary Exchange
Regarding capillary transport, which of the following statements is INCORRECT:
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Lymphatic Drainage of the Testis
A 29 year patient presents to ED complaining of a painless lump in his scrotum. Imaging shows a tumour affecting the scrotum but sparing the
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Renal Handling of Potassium
Renal regulation of potassium is primarily controlled by which of the following hormones:
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Structure of the Tracheobronchial Tree
A 5 year old girl is brought in to ED having inhaled a small plastic object. Where in the tracheobronchial tree is the object most likely to
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Heparin: Comparison of Drugs
Which of the following is a benefit of low molecular weight heparin (LMWH) over unfractionated heparin therapy:
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Pharmacological Management of Hypokalaemia
Regarding potassium replacement, which of the following statements is INCORRECT:
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Blood Supply of the Duodenum
The arterial supply of the duodenum is primarily derived from which of the following:
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Risk Factors for Legionnaires' Disease
A patient presents to ED unwell with a high fever, breathlessness and a cough. Chest x-ray demonstrates a left lower lobe pneumonia. His CUR
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Organelles of Eukaryotic Cells
Regarding the human cell, which of the following cell organelles is responsible for protein assembly:
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Glucagon: Indications
Glucagon may be used as an antidote for overdose with which of the following:
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Production of Glucagon
Alpha cells of the endocrine pancreas produce which of the following hormones:
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Function of the Quadriceps Femoris Muscle
An 18 year old man is brought into the ED after sustaining a deep wound to his left thigh after an accident on a building site. Imaging has
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Spread of Infection
Which of the following microbes is primarily transmitted via invasion of intact skin:
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Function of the Levator Palpebrae Superioris Muscle
Which of the following muscles is responsible for opening the eye:
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Clinical Effects of Ulnar Nerve Injury
A 29 year old fell heavily while base-jumping and presents to ED with a painful right arm. X-ray shows a fracture of the medial epicondyle.
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Attachments of the Gluteus Medius Muscle
Which of the following muscles insert onto the greater trochanter.
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Mechanism of the Baroreceptor Reflex
When an elderly dehydrated patient is moved from a supine to a standing position, her blood pressure decreases and heart rate increases. Whi
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Function of the Pectoralis Minor Muscle
A 35 year old man presents to the ED after falling approximately 1 metre from a ladder, landing on his right shoulder. Your consultant exami
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Functional Anatomy of the Small Intestine
Which of the following is not secreted by the brush border:
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Structure of the Uterine Tube
Regarding the uterine tubes, which of the following statements is CORRECT:
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Function of the Hamstring Muscles
A 32 year old man presents to the ED after sustaining multiple stab wounds to the right thigh during an altercation in a pub. Imaging has sh
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Function of the Adrenal Medulla
Regarding the adrenal medulla, which of the following statements is INCORRECT:
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Lithium: Toxicity
Which of the following does NOT predispose to lithium toxicity in patients taking long-term therapy:
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Doxycycline: Side Effects
Which of the following side effects is most likely attributed to doxycycline:
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Branches of the Mandibular Nerve
The auriculotemporal nerve carries general sensation from all of the following regions EXCEPT for the:
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Water Absorption in the Small Intestine
Whilst on working an elective in Nigeria a patient presents to hospital with profuse watery diarrhoea. Your supervising consultant suspects
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Blood Supply of the Kidney
The renal arteries arise from the abdominal aorta at which of the following vertebral levels:
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Function of the Gut Flora
Regarding the intestinal bacterial flora, which of the following statements is CORRECT:
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Statins: Drug Interactions
A patient requires antibiotic treatment for an infection. You are aware that the patient is on long-term statin therapy. Which of the follow
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Mechanism of Vitamin B12 Absorption
A 28 year old patient with known inflammatory bowel disease presents to ED with surgical complications following his recent ileocaecal resec
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Complications of Measles
Which of the following complications is primarily associated with measles:
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Flecainide: Mechanism of Action
A patient presents with symptomatic fast atrial fibrillation. Your consultant decides to use flecainide. What is the main mechanism of actio
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Transmission of Roundworm Infection
A student who has recently returned from volunteering in sub-Saharan Africa presents to ED complaining that she has seen a worm in her stool
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Clinical Features of Phaeochromocytoma
A 32 year old woman presents with episodes of flushing, headaches and palpitations. On examination her blood pressure is significantly eleva
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Attachments of the Psoas Major Muscle
The psoas major muscle originates from which of the following:
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Innervation of the Jejunum and Ileum
Pain in the jejunum and ileum is typically referred to which of the following regions:
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Sodium Bicarbonate Solution: Indications
Which of the following is the most appropriate indication for intravenous sodium bicarbonate:
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Calculation of Positive Likelihood Ratio
A new test is being developed to diagnose chlamydia. 1000 people aged 15 – 35 years attending a GUM clinic undergo the new test and the cu
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Factors affecting Airway Resistance
Regarding airway resistance, which of the following statements is INCORRECT:
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Complications of Campylobacter Gastroenteritis
A patient presents to ED with a profuse bloody diarrhoea. Stool culture confirms infection with Campylobacter jejuni. Which of the following
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Muscles of the Posterior Abdominal Wall
Which of the following best describes the relationship of the psoas major and quadratus lumborum muscles:
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Skull Exit Locations of the Cranial Nerves
A 54 year old man presents to ED with severe headaches and vomiting. Imaging shows a tumour causing compression at the jugular foramen. Whic
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Phases of Gastric Secretion
Regarding the cephalic phase of gastric secretion, which of the following statements is CORRECT:
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Production of Atrial Natriuretic Peptide
Atrial natriuretic peptide (ANP) is primarily produced by which of the following:
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Enterohepatic Circulation of Bile Acids
About what percentage of bile acids undergo enterohepatic circulation:
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Function of Parathyroid Hormone
How does parathyroid hormone (PTH) affect renal handling of phosphate:
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Pharmacological Management of DKA
Regarding the management of diabetic ketoacidosis (DKA), if the systolic BP is initially < 90 mmHg, which of the following should be give
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Branches of the Facial Nerve
A patient presenting with nerve injury has sparing of the upper half of the orbicularis oculi muscle but not the lower half. The lower half
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Relative Ionic Distribution in Fluid Spaces
Which of the following ions has a higher concentration in intracellular fluid than in extracellular fluid:
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Function of the Renin-Angiotensin-Aldosterone System
Which of the following is a response to increased sympathetic innervation to the kidney following a fall in extracellular volume:
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Iron Deficiency Anaemia
In iron deficiency anaemia, which of the following would you NOT expect to see:
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Phases of the Cardiac Cycle
You are teaching a group of medical students about cardiovascular examination. You are discussing heart sounds and the cardiac cycle. Which
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Coagulation Cascade
Regarding the coagulation cascade, the extrinsic pathway requires which of the following clotting factors:
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Function of Thyrotropin-Releasing Hormone
Which of the following stimulates thyroid-stimulating hormone (TSH) release from the anterior pituitary:
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Clinical Effects of Ulnar Nerve Injury
A 29 year old woman presents to ED after injuring her left elbow. She is complaining of weak grip in her left hand. You ask her to hold onto
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Causative Agent of Scarlet Fever
A 5 year old child is brought to ED with a widespread sandpaper-like rash and a sore tongue shown below. She has been off school over the l
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Calculation of Cardiac Output
A patient has a cardiac output of 4.8 L/min and a heart rate of 80 bpm, therefore their stroke volume is:
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Anatomical Relations of the Stomach
Which of the following structures does not make up part of the stomach bed:
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Movements of the Foot Joints
Inversion of the foot is primarily produced by which of the following muscles:
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Organelles of Eukaryotic Cells
You are seeing a child with known mitochondrial disease who has presented breathlessness and cough. Which of the following best describes th
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Inotropic Effects on the Heart
Digoxin exhibits its positive inotropic effect by which of the following mechanisms:
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Constrictions of the Ureter
Which of the following best describes the main sites of constriction of the ureters:
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Menisci of the Knee Joint
A 28 year old presents to the ED after sustaining a right knee injury whilst skiing. You examine the knee and suspect a medial meniscal inju
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Ligaments of the Hip Joint
A 76 year old woman present to the ED after feeling in a "pop" in her right hip. She recently underwent a right total hip replacement, you s
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Anatomical Location of the Adrenal Gland
The adrenal gland is located in which of the following regions:
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Sickle Cell Disease
Which of the following is the most common clinical manifestation of sickle cell disease:
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Management of Urinary Tract Infection
A 36 year old woman presents to ED complaining of fever and left flank pain. She has been having urinary frequency and urgency over the last
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Boundaries of the Inguinal Canal
The roof of the inguinal canal is formed primarily by which of the following structures:
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Features of Hypernatraemia
Regarding hypernatraemia, which of the following statements is INCORRECT:
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Function of Parathyroid Hormone
A patient presents with abdominal pain and constipation. Bloods show hypocalcaemia. Hypocalcemia causes an increase in which of the followin
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Shift of the Oxygen Dissociation Curve
The following all cause a right shift in the oxygen dissociation curve EXCEPT for:
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Calculation of Range
What is the range of the following data set; 3, 7, 5, 13, 20, 23, 39, 23, 40, 23, 14, 12, 56, 23, 29:
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Intraperitoneal vs Retroperitoneal Organs
A 23 year old patient is brought to ED following a road traffic accident. CT imaging demonstrates retroperitoneal injury. Which of the follo
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Fascia of the Spermatic Cord
A 40 year old man is undergoing a vasectomy. During the procedure the various layers of the spermatic cord are separated to expose the ductu
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Clinical Features of Hyperthyroidism
Which of the following clinical features is NOT a typical feature of hyperthyroidism:
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Suxamethonium: Pharmacology
Regarding suxamethonium, which of the following statements is CORRECT:
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Function of the Musculocutaneous Nerve
Your consultant asks you to examine a patient he has seen. He suspects he may have a traumatic musculocutaneous nerve injury. The musculocut
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Calculation of the Anion Gap
You are calculating the anion gap of an unconscious patient with a metabolic acidosis. Which of the following anions are required to calcula
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Surface Anatomy of the Heart
A 19 year old woman is brought to the ED having been stabbed in the chest. She has sustained a penetrating wound in the left fourth intercos
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Disseminated Intravascular Coagulation
A 62 year old female is brought to ED with sepsis. The patient is in shock and has a purpuric rash. The peripheral blood smear shows thrombo
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Attachments of the Latissimus Dorsi Muscle
An 85 year old man presents to the ED following a fall at home. On examination you note he is tender over the distal attachment of the latis
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Cortical Areas of the Temporal Lobe
The primary auditory cortex is located in which of the following regions:
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Granulomatous Inflammation
Which of the following conditions is NOT typically associated with granulomatous inflammation:
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Pharmacological Management of Acute Asthma
A 35 year old woman presents to ED with an acute asthma attack and you are asked to prescribe steroids. What is the most appropriate dose of
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Compartments of the Peritoneal Cavity
The greater sac of the peritoneal cavity is divided into two compartments by which of the following structures:
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Adenosine: Drug Interactions
The dose of adenosine must be quartered if given concomitantly in a patient taking which of the following drugs:
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