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Date Completed: 19/11/2023
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Clinical Features of Hyperthyroidism
A 45 year old woman complains of weight loss, palpitations and heat intolerance. On examination you note tachycardia, finger clubbing and ey
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Mechanism of Ventilation-Perfusion Mismatch
Regarding V/Q mismatch, which of the following statements is INCORRECT:
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Cutaneous Innervation of the Upper Limb
A 23 year old woman presents to the Emergency Department complaining of a painful swelling in her right axilla. On examination you note a te
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Boundaries of the Femoral Ring
A 87 year old woman presents to the ED after her carers noted she was complaining of pain in the right groin. On examination you note a tend
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Anaemia of Chronic Disease
Regarding anaemia of chronic disease, which of the following laboratory findings would you NOT expect to see:
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Function of the Endothelium
Regarding endothelium derived nitric oxide, which of the following statements is INCORRECT:
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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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Clinical Effects of Rotator Cuff Injury
A patient presents to ED having injured his right shoulder playing basketball. You establish he has torn the most commonly injured rotator c
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Attachments of the Psoas Major Muscle
The psoas major muscle originates from which of the following:
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Boundaries of the Femoral Triangle
You are discussing clinically relevant lower limb anatomy with a group of medical students. The femoral triangle is an important, clinically
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Pathogenesis of Tuberculosis
An immunocompromised patient originally from Nigeria, complaining of a persistent cough and haemoptysis, is sent to ED by his GP with suspec
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Calculation of Negative Predictive Value
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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Calculation of Mean
What is the mean of the following data set: 13, 18, 13, 14, 13, 16, 14, 21, 13
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Tetracyclines: Pharmacology
Regarding tetracycline antibiotics, which of the following statements is INCORRECT:
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Muscles of the Thoracic Wall
Regarding the muscles of the thoracic wall, which of the following statements is CORRECT:
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Boundaries of the Popliteal Fossa
A 67 year old man presents to the ED complaining of pain and swelling to the posterior knee. On examination you note a tender swelling in th
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Structure of the Glomerular Filtration Barrier
Regarding the glomerular filtration barrier, which of the following statements is CORRECT:
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Characteristics of Clostridium Tetani
Regarding Clostridium tetani, which of the following statements is CORRECT:
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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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Relative Ionic Distribution in Fluid Spaces
Which of the following ions has a higher concentration in extracellular fluid than in intracellular fluid:
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Abnormal Bleeding
Regarding screening tests for clotting, which of the following statements is CORRECT:
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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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Control of Exocrine Pancreas Secretion
Regarding the exocrine pancreas, which of the following statements is CORRECT:
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Propagation of an Action Potential
Regarding conduction of nerve impulses, which of the following statements is CORRECT:
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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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Mechanism of the Baroreceptor Reflex
The afferent component of the baroreceptor reflex is carried in which of the following:
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Microbial Mechanisms of Attachment
An elderly patient presents to ED with fever, cough, coryza, and systemic features of malaise and myalgia. Your consultant suspects influenz
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Innervation of the Iliacus Muscle
You are assessing a 76 year old woman who presents with weakness to the left hip following a fall. She is pain free. On examination she has
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Prednisolone: Indications
Prednisolone would be most useful for which of the following conditions:
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Surface Anatomy of the Pancreas
The body of the pancreas lies at which of the following vertebral levels:
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Innervation of the Temporalis Muscle
The temporalis muscle is innervated by which of the following nerves:
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Action Potential of the Ventricular Myocyte
In ventricular myocytes, repolarisation occurs because of a:
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Microbial Mechanisms of Attachment
A 21 year old girl presents to ED with abdominal cramps and watery diarrhoea. Her boyfriend has recently returned from travelling abroad and
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Function of Pulmonary Surfactant
A patient is brought to ED with worsening breathlessness. They are known to have a genetic surfactant dysfunction disorder. What is the func
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Chronic Myeloid Leukaemia
Regarding chronic myeloid leukaemia, which of the following statements is CORRECT:
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Management of Osteomyelitis
A 45 year old known intravenous drug user presents to ED with a fever complaining of pain over his big toe which has been getting worse over
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Surfaces of the Heart
The right pulmonary surface of the heart is formed predominantly by which of the following:
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Lymphatic Drainage of the Ovary
A 39 year old patient complains of abdominal pain. Imaging shows tumours in both ovaries. Which of the following lymph nodes are the first
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Ligaments of the Ankle Joint
A 21 year old professional athlete sustains an inversion injury to her left ankle during the 800m. Which of the following ligaments is most
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Definition of Lung Volumes and Capacities
Inspiratory capacity (IC) is calculated using which of the following:
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Measurement of Renal Clearance
Glomerular filtration rate can be calculated using any substance that:
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JVP Waveforms during the Cardiac Cycle
Which of the following JVP waveforms corresponds with atrial systole:
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ALS Treatment Algorithm
In adult advanced life support, the defibrillator pads should be placed at which of the following positions:
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Function of the Pituitary Gland
Which of the following is a physiological function that is mediated by a hormone released by the posterior pituitary:
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Mechanism of Vitamin B12 Absorption
Vitamin B12 is primarily absorbed in which part of the gastrointestinal tract:
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Phases of the Cardiac Cycle
At the start of the cardiac cycle, all of the following statements are true EXCEPT for:
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Mechanism of Protein Digestion
Regarding protein digestion, which of the following statements is CORRECT:
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Acute Lymphoblastic Leukaemia
Which of the following leukaemias is most common in children in the UK:
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Functional Anatomy of the Small Intestine
Regarding the small intestine, which of the following statements is INCORRECT:
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Pathogenesis of Tetanus
Regarding Clostridium tetani, which of the following statements is CORRECT:
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Anatomical Relations of the Heart
Which of the following structures lies immediately posterior to the base of the heart:
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Contents of the Femoral Sheath
A 53 year old man presents to the ED after falling from a horse onto a fence. Imaging has shown trauma to the contents of the left femoral s
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Clinical Effects of Trochlear Nerve Lesion
A 55 year old woman presents to ED complaining of vertical diplopia with difficulty walking downstairs. She is tilting her head to one side
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Coagulation Cascade
Regarding the coagulation cascade, the intrinsic pathway is primarily activated by which of the following:
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Dermatomal Supply of the Thoracic Wall
Which of the following dermatomes is located at the level of the nipples:
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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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Pathogenesis of Tetanus
A patient presents to ED with neck stiffness and trismus which has developed over the last 24 hours. About 10 days ago he sustained a punctu
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Attachments of the Popliteus Muscle
Which of the following muscle tendons enters the joint capsule of the knee:
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Dermatomal Supply of the Lower Limb
A 23 year old horse rider is brought to the ED following a fall during a show jumping competition. She complains of pain in her lumbar spine
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Incubation Period of Respiratory Syncytial Virus
The incubation period of respiratory syncytial virus (RSV) is about:
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Clinical Effects of Brachial Plexus Injury
A 23 year old woman is brought into ED having been thrown off horseback during a competition. She has no major injuries but is complaining o
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Antiplatelets
Aspirin works as an antiplatelet drug through its ability to inhibit the synthesis of:
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Anatomical Relations of the Colon
Which of the following is NOT an anterior relation of the transverse colon:
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Characteristics of Statistical Power
Regarding the power of a study, which of the following statements is INCORRECT:
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Assessment of the Sternocleidomastoid Muscle
A 29 year old male presents to ED with a penetrating injury to the neck. You suspect injury to the right sternocleidomastoid muscle. How wou
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Management of Infective Endocarditis
A 27 year old man is sent in by his GP. He is complaining of a general malaise and fever over the last week and his GP has noted a new harsh
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Innervation of the Peritoneum
Irritation of the central part of the diaphragmatic peritoneum is typically referred to:
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Innervation of the Psoas Major Muscle
A 65 year old man presents with weakness in the right hip, most marked on flexion. You consider the possibility of a psoas major pathology.
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Organisation of Skeletal Muscle
The connective tissue surrounding the whole skeletal muscle is called:
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Auscultation Position of the Heart Valves
You are performing a full cardiovascular examination on a patient presenting to ED with palpitations. The mitral valve is best auscultated a
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Anatomical Course of the Hypoglossal Nerve
The hypoglossal nerve emerges from the cranial cavity through the:
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Routine Immunisation Schedule
All of the following additional vaccines are recommended for UK health workers EXCEPT for:
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Characteristics of Escherichia Coli
Regarding Escherichia coli, which of the following statements is INCORRECT:
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Pharmacological Management of Thiamine Deficiency
A 64 year old man, with a history of chronic alcohol abuse, presents to ED in alcohol withdrawal as he ran out of beer money. He is unkempt
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Characteristics of Legionella Spp.
Regarding Legionella species which of the following statements is CORRECT:
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Anatomy of the Anterior Arm Muscles
A 48 year old man presents to the ED complaining of pain in his right arm. He has a history of intravenous drug use. He has marked erythema
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Complement Cascade
Which of the following complement proteins is the most important for opsonisation of antigen:
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Distribution of Myotomes
A 74 year old man presents with a three month history of worsening left shoulder and arm pain. On examination there is weakness of shoulder
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Management of Diabetic Ketoacidosis
A 21 year old women, with known diabetes mellitus, is brought to ED with diabetic ketoacidosis (DKA). An insulin infusion would be expected
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ALS Treatment Algorithm
In adult advanced life support, which of the following best describes the correct administration of adrenaline for a non-shockable rhythm:
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Ciprofloxacin: Drug Interactions
Regarding drug interactions with ciprofloxacin, which of the following statements is INCORRECT:
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Innervation of the Gluteus Minimus Muscle
You are performing a thorough neurological examination of a 67 year old female patient. You note marked wasting of the left hip and thigh mu
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Muscle Relaxants: Mechanism of Action
Which of the following is a depolarising muscle relaxant drug:
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Anatomical Relations of the Uterus
Regarding the relations of the uterus, which of the following statements is INCORRECT:
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Production of Glucagon
Alpha cells of the endocrine pancreas produce which of the following hormones:
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Obstructive vs Restrictive Lung Disease
A patient with known COPD presents to ED with worsening breathlessness. You are looking at her old notes and noticed recent spirometry resul
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Clinical Features of Primary Hyperthyroidism
Which of the following biochemical patterns is most typical of primary hyperthyroidism:
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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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Anatomical Relations of the Ureter
Within the pelvic cavity in women, the ureter is crossed anteriorly by which of the following structures:
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Arteries of Kiesselbach's plexus
A 45 year old man presents to ED with an ongoing nose bleed. On examination you suspect the site of bleeding to be in Little's area. Which o
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Contents of the Popliteal Fossa
A 26 year old male has sustained a stab wound to the popliteal fossa and has injured the most lateral structure within this region. Which o
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Control of Gastric Acid Secretion
Histamine is secreted by which of the following cell types in the stomach:
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Anatomy of the Female Urethra
Regarding the female urethra, which of the following statements is CORRECT:
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Calculation of Sensitivity
A new blood test is being developed to diagnose DVT. 1000 people presenting to ED with suspected DVT undergo the new blood test and the gol
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Routine Immunisation Schedule
Pneumococcal conjugate vaccine (PCV) is given at which of the following intervals in the UK routine childhood immunisation schedule:
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Innervation of the Trapezius Muscle
You are examining the shoulder of a 43 year old woman who complains of progressive weakness in her left arm. You note wasting of the left tr
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Calculation of Number Needed to Treat
A new chemotherapy drug is being tested. The intervention reduces the risk of death from 10 in 1000 to 5 in 1000. What is the number needed
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Complications of Clostridium Difficile Colitis
A patient is sent to ED by his GP with profuse watery diarrhoea. A stool sample taken by the GP has demonstrated C. difficile cytotoxin. Whi
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Movements of the Shoulder Joint
A 28 year old man involved in a road traffic collision, is unable to abduct his arm at the glenohumeral joint. Which of the following nerves
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Clinical Features of Cushing's Syndrome
A 70 year old woman with known rheumatoid arthritis complains of weight gain, muscle weakness and ankle swelling. She has resistant hyperten
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Function of the Orbicularis Oris Muscle
The orbicularis oris muscle is responsible for which of the following:
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Right to Left Shunts in Physiology
Regarding right to left shunts, which of the following statements is CORRECT:
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Blood Supply of the Scalp
Regarding the blood supply of the scalp, which of the following statements is INCORRECT:
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Cutaneous Innervation of the Face
A 20 year old man presents to ED following an alleged assault with a laceration to the lower central part of the midline forehead. He requir
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Inhaled Corticosteroids: Pharmacology
Regarding inhaled corticosteroids, which of the following statements is CORRECT:
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Function of the Endothelium
Endothelin-1 release from endothelium is stimulated by all of the following EXCEPT for:
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Function of the Posterior Leg Muscles
The muscles of the posterior compartment of the leg collectively act together to primarily produce which of the following movements:
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Clinical Effects of UInar Nerve Injury
A 16 year old boy is brought to ED having fallen off his skateboard. He is complaining of pain and weakness in his right upper limb. Imaging
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Function of the Juxtaglomerular Apparatus
What is the role of the juxtaglomerular (granular) cells of the juxtaglomerular apparatus:
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Clinical Features of Meningococcal Disease
A 23 year old man presents to ED complaining of a headache with neck stiffness and photophobia. On examination you note a non-blanching purp
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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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Vasoconstriction vs Vasodilation
Which of the following is a vasodilating agent which plays a vital role in regulation of vascular tone:
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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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Components of Normal Bacterial Flora
Which of the following is NOT typically present in intestinal flora:
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Clinical Features of Primary Adrenal Insufficiency
A 58 year old woman with known autoimmune hypothyroidism presents to ED with flu-like symptoms and circulatory collapse. She reported weight
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Propofol: Mechanism of Action
A 47 year old woman requires procedural sedation for DC cardioversion of atrial fibrillation. You plan to use propofol. Sedation is more lik
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Clinical Effects of Hypokalaemia
Which of the following is NOT an ECG change typically associated with hypokalaemia:
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Function of the Pituitary Gland
Which of the following hormones is NOT secreted by the anterior pituitary gland:
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Disturbance of Acid-Base Balance
What pattern of acid-base disturbance is shown by the blood gas results (on normal air) below: pH = 7.37 PaO2 9 kPa PaCO2 = 7.5 k
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Definition of Lung Volumes and Capacities
Which of the following best describes the vital capacity (VC):
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Functional Anatomy of the Heart
Regarding the heart, which of the following statements is CORRECT:
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Pharmacological Management of DKA
Regarding the management of diabetic ketoacidosis (DKA), which of the following statements is INCORRECT:
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Anatomy of the External Oblique Muscle
Regarding the external oblique muscle, which of the following statements is INCORRECT:
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Mechanism of Action of Diuretics
Regarding diuretics, which of the following statements is CORRECT:
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Factors affecting Statistical Power
Which of the following does NOT increase the power of a study:
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Sodium Nitroprusside: Contraindications
Sodium nitroprusside is contraindicated in which of the following:
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Key Anatomical Landmarks in Tracheotomy
The anaesthetist is attempting to intubate an unconscious patient who is unable to maintain their airway. The anaesthetist finds himself in
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Intraperitoneal vs Retroperitoneal Organs
A 36 year old male is brought into ED complaining of fever, abdominal pain and tenderness. Imaging shows that an abdominal infection has spr
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Characteristics of the Cutaneous Circulation
Regarding the cutaneous circulation, which of the following statements is CORRECT:
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Production of Gastrin
Gastrin release from antral G-cells is stimulated by all but which one of the following:
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Function of Pulmonary Surfactant
Regarding pulmonary surfactant, which of the following statements is CORRECT:
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Dexamethasone: Indications
Dexamethasone would be most useful for which of the following conditions:
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Attachments of the Lumbrical Muscles
A 21 year old man presents to the ED after sustaining a penetrating knife injury to the hand. You suspect injury to the structure attached
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Action Potential of the Sinoatrial Node
What is the resting membrane potential of the sinoatrial node:
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Beta-2 Agonists: Mechanism of Action
Selective beta-2 agonists predominantly have which of the following clinical effects:
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Heparin: Comparison of Drugs
Which of the following is a benefit of unfractionated heparin over low molecular weight heparin (LMWH) therapy:
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Definition of Lung Volumes and Capacities
Which of the following best describes the tidal volume (TV):
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Regulation of Aldosterone
Which of the following hormones is released in direct response to high plasma [K+]:
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ACE inhibitors: Drug Interactions
The risk of renal impairment in a patient on ACE inhibitor therapy is increased by concomitant treatment with which of the following drug cl
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Acute Myeloid Leukaemia
Regarding acute myeloid leukaemia (AML), which of the following statements is CORRECT:
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Innervation of the Appendix
A 24 year old man presents to ED complaining of severe sharp abdominal pain in his right iliac fossa. Which of the following most accurately
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Anatomical Relations of the Aorta
A 50 year old man presents to ED complaining of a hoarse voice. Imaging shows an aneurysm of the aortic arch. Which of the following structu
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Renal Handling of Phosphate
Regarding renal phosphate handling, which of the following statements is CORRECT:
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Contents of the Popliteal Fossa
A 24 year old man sustains a laceration of his left leg that transects the superficial vein that enters the popliteal fossa to terminate in
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Structure of the Lymphatic System
Regarding the lymphatic system, which of the following statements is CORRECT:
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Ligaments of the Radioulnar Joints
You have been asked to review a patient with a Monteggia fracture. The proximal radioulnar joint is primarily supported by which of the foll
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Mechanism of Protein Digestion
Which of the following is transported in intestinal epithelial cells by a Na+-dependent cotransport process:
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Function of the Trapezius Muscle
You are examining the left shoulder of a woman who complains of progressive weakness in the left arm. On examination you detect a weakness i
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Nitrous Oxide: Pharmacology
Regarding nitrous oxide, which of the following statements is CORRECT:
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Pathway of the Corneal Blink Reflex
Which of the following nerves is the efferent pathway of the corneal blink reflex:
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Anatomical Boundaries of the Neck Triangles
Regarding the neck, which of the following statements is CORRECT:
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Anatomy of the Vertebral Canal
A 19 year old student presents to ED with a headache, fever and photophobia. You suspect meningitis and agree to observe your junior perform
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