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Date Completed: 20/11/2023
Page 1 of 18
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Production and Function of Saliva
Regarding control of saliva secretion, which of the following statements is INCORRECT:
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Management of Bradyarrhythmias
What is the initial recommended dose for atropine in the treatment of bradyarrhythmias associated with adverse features or a risk of asystol
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Lesions of the Visual Pathway
A patient presents with headache and loss of vision. CT head shows a tumour in the left temporal lobe. Which of the following visual field d
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Innervation of the Orbicularis Oris Muscle
The orbicularis oris muscle is innervated by which of the following nerves:
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Production of Gastrin
Gastrin release from antral G-cells is inhibited by all but which one of the following:
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Function of Aldosterone
Aldosterone primarily acts at which of the following sites in the renal nephron:
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Mechanism of Postural Hypotension
What is the initial physiological effect resulting in postural hypotension:
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Orbital Floor Fracture with Inferior Rectus Entrapment
A 28 year old man presents to ED with pain and blurred vision after being hit in the eye with a fast-moving ball while playing squash. On fu
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Function of the Sternocleidomastoid Muscle
The sternocleidomastoid 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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Clinical Features of Gonorrhoea
A 21 year old male patient attends ED with a profuse thick green urethral discharge and dysuria. What is the most likely causative pathogen:
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Compartments of the Peritoneal Cavity
A 26 year old woman is brought to ED following a road traffic accident. Focussed assessment for sonography in trauma (FAST) on the supine pa
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Heart Sounds during the Cardiac Cycle
Regarding the heart sounds in the cardiac cycle, which of the following statements is INCORRECT:
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Function of Activated Vitamin D
What is the effect of activated vitamin D on the renal handling of calcium:
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Production and Function of Antidiuretic Hormone
Regarding antidiuretic hormone (ADH) which of the following statements is CORRECT:
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Drainage of the Paranasal Sinuses
Regarding the paranasal sinuses, which of the following statements is INCORRECT:
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Pharmacological Management of Status Epilepticus
A 21 year old patient with known epilepsy is brought into ED by her parents in status epilepticus. You proceed to give intravenous lorazepam
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Ligaments of the Elbow Joint
A 23 year old woman presents to the ED after falling and sustaining a dislocation of the right elbow. Regarding the ligaments of the elbow,
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Definition of Negative Predictive Value
Which of the following best describes the negative predictive value of a diagnostic test:
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Interpretation of Forest Plots
Regarding forest plots in meta-analysis, the midpoint of the square represents:
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Anatomical Relations of the Kidney
The left kidney is related anteriorly to all of the following structures EXCEPT for the:
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Function of the Femoral Nerve
You form part of the trauma team caring for a roofer who fell approximately 7 metres from a roof, landing across a beam. Imaging of the spin
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Management of Hypertensive Crisis
Regarding hypertensive crises, which of the following statements is CORRECT:
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Definition of Einthoven's Triangle
Regarding Einthoven's triangle, which of the following statements is CORRECT:
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Assessment of the Rotator Cuff Muscles
Your consultant performs a thorough shoulder examination on a patient with suspected rotator cuff injury on his left side. He asks the patie
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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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Function of Parathyroid Hormone
You are reviewing a patient with hypocalcaemia secondary to hypoparathyroidism. Parathyroid hormone (PTH) acts to increased calcium reabsorp
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Articulations of the Ribs
A 35 year old woman is brought to ED having been involved in a road traffic accident. She has sustained a chest injury on impact with the st
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Ligaments of the Vertebral Column
Regarding the ligaments of the spinal column, which of the following statements is INCORRECT:
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Vancomycin: Indications
All of the following antibiotics are commonly implicated in causing C. difficile colitis EXCEPT for:
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Flucloxacillin: Indications
Flucloxacillin is used first line for all of the following infections EXCEPT for:
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Clinical Features of Primary Adrenal Insufficiency
Which of the following clinical features is typical of Addison's disease:
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Assessment of the Rotator Cuff Muscles
A 39 year old woman presents to ED with a painful left shoulder. Your consultant is completing a mini-CEX and is observing you performing a
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Characteristics of Respiratory Syncytial Virus
Regarding respiratory syncytial virus (RSV), which of the following statements is INCORRECT:
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Structure of the Common Bile Duct
The common bile duct is formed from which of the following structures:
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Movements of the Shoulder Joint
Following a road traffic accident, a patient has difficulty laterally rotating his arm. Which of the following muscles have most likely been
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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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Transmission of Campylobacter Jejuni
Campylobacter jejuni is primarily spread via which of the following routes:
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Production and Function of Insulin
Regarding insulin, 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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Function of the Obturator Externus Muscle
A 19 year old man self presents to the ED following a fight in a nearby street. He has sustained multiple stab wounds and lacerations to the
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Renal Handling of Potassium
Renal potassium excretion is promoted by all but which one of the following:
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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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Anatomical Course of the Great Saphenous Vein
A 65 year old woman presents to the ED with a tender left leg. She has been assessed by your Consultant colleague who feels she may have thr
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Relative Fluid Distribution in Fluid Spaces
Regarding fluid balance, which of the following statements is CORRECT:
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Ipratropium Bromide: Mechanism of Action
You are prescribing ipratropium bromide for a patient who has presented with an exacerbation of her COPD. What is the mechanism of action of
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Mechanism of Skeletal Muscle Contraction
The two principal contractile proteins in skeletal muscle are:
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Definition of Lung Volumes and Capacities
You are reviewing a patient who has presented with breathlessness. She tells you she has recently undergone lung function tests. Which of th
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Renal Handling of Urea
Regarding renal handling of urea, which of the following statements is INCORRECT:
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Multiple Myeloma
A 75 year old female presents to ED with right arm pain. X-ray shows lytic bone lesions and you suspect multiple myeloma. Overproduction of
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Phases of the Cardiac Cycle
In the atrial systolic phase of the cardiac cycle, all of the following statements are true EXCEPT for:
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Measuring Spread using Standard Deviation
A range of one standard deviation above and below the mean includes what approximate percentage of the sample values:
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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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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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Warfarin: Drug Interactions
Which of the following drugs may enhance the anticoagulant effect of warfarin:
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Mechanism of Postural Hypotension
Regarding postural hypotension, which of the following statements is INCORRECT:
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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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Investigation of Helicobacter Pylori Infection
A patient presents to ED recurrently with symptoms of dyspepsia. Your consultant asks you to find out if the patient has previously been tes
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Function of the Loop Of Henle
Regarding the loop of Henle, which of the following statements is CORRECT:
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Cell Staining in Microscopy
Giemsa-stained blood film microscopy is typically used for the diagnosis of which of the following:
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Renal Handling of Sodium
Regarding Na+ handling in the kidney, which of the following statements is CORRECT:
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Clinical Features of Diabetes Insipidus
Diabetes insipidus is characterised by which of the following:
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Clinical Features of Hepatitis D Infection
Regarding hepatitis D which of the following statements is CORRECT:
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Definition of Type I Error
If the null hypothesis is wrongly rejected when it is actually true, this is an example of:
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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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Innervation of the Stylopharyngeus Muscle
The stylopharyngeus muscle of the pharynx is innervated by which of the following nerves:
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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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Characteristics of Klebsiella Spp.
Regarding Klebsiella spp. which of the following statements is CORRECT:
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ECG Deflections during the Cardiac Cycle
Which of the following represents ventricular depolarisation on the ECG:
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Beta-Blockers: Contraindications
A 32 year old presents to ED with palpitations ongoing for the past 5 days. ECG demonstrates atrial fibrillation with a rate of 165 bpm with
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Clinical Effects of Alpha-1 Antitrypsin Deficiency
Alpha-1 antitrypsin deficiency causes which of the following:
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ALS Treatment Algorithm
A patient suddenly collapses in the waiting room with no detectable pulse. The initial rhythm check shows a non-shockable rhythm and you pre
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Structure of the Peripheral Vascular System
Which of the following type of blood vessel contributes the most to total peripheral resistance:
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Phases of the Cardiac Cycle
Regarding the cardiac cycle, which of the following statements is CORRECT:
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Anatomy of the Interosseous Muscles
A 67 year old patient complains of weakness of abduction and adduction of his fingers. You suspect weakness of the interossei. Regarding the
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Anatomical Relations of the Urinary Bladder
The male bladder lies immediately anterior to which of the following structures:
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Location of the Brainstem Nuclei
Which of the following brainstem nuclei is NOT located in the pons:
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Mechanism of Fat Digestion
Micelle formation is necessary for the intestinal absorption of which of the following:
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ACE Inhibitors: Side Effects
A patient who is taking ramipril for high blood pressure complains of a dry persistent cough. What is the mechanism of cough in ACE inhibito
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Anatomical Relations of the Ureter
A 49 year old female patient undergoes surgery for uterine cancer. Whilst attempting to ligate the uterine artery, the surgeon accidentally
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Articulations of the Knee Joint
Which of the following synovial joint types best describes the knee joint:
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Layers Penetrated During Lumbar Puncture
A 21 year old student is sent in to ED by his GP with suspected meningitis. You are about to perform a lumbar puncture. Which of the followi
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Conduction System of the Heart
A 42 year old man presents to ED complaining of feeling light-headed. At triage, his heart rate is found to be 40-60 bpm regular rhythm. ECG
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Function of the Loop of Henle
In which part of the loop of Henle is Na+ reabsorbed via the Na+/K+/2Cl- symporter:
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Anatomy of the Paranasal Sinuses
Regarding the paranasal sinuses, which of the following statements is INCORRECT:
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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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Pharmacological Management of Status Epilepticus
After what time period should pharmacological treatment be commenced in a patient with an ongoing convulsive seizure:
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Transport across a Cell Membrane
Which of the following is characterised by passive carrier-mediated transport down a chemical concentration gradient across a cell membrane:
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Management 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. Fir
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Surface Anatomy of the Heart Valves
Which of the following best describes the surface marking of the aortic valve:
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Function of Lung Receptors
A 55 year old women presents to ED with a chronic cough. Which of the following pulmonary receptors is likely to be involved in causing her
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Skull Exit Locations of the Cranial Nerves
A 64 year old lady presents to ED with headaches. Imaging show a tumour compressing the structures in the internal auditory meatus. Which of
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Anatomical Relations of the Colon
Which of the following structures is NOT a posterior relation of the transverse colon:
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Characteristics of Streptococcus Pneumoniae
Regarding Streptococcus pneumoniae, which of the following statements is CORRECT:
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Benzodiazepines: Mechanism of Action
You are being observed performing procedural sedation in the Emergency Department. You have been advised to use midazolam. At what receptor
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Principles of Oxygen Therapy
In patients requiring oxygen, who are at risk of hypercapnic respiratory failure, oxygen saturations should be maintained at:
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Control of Exocrine Pancreas Secretion
Digestive enzymes are secreted from which cell type in the pancreas:
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Anatomical Location of the Pituitary Gland
A 49 year old patient presents to ED complaining of ongoing headaches. She is awaiting the results of a CT head scan she had done 2 days ago
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Clinical Effects of Hypokalaemia
Which of the following is NOT a clinical feature of hypokalaemia:
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Layers of the Sole of the Foot
The tendons of the tibialis posterior and fibularis longus muscles lie within which of the muscular layers of the sole of the foot:
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Origin of the Basilar Artery
The basilar artery is formed from which of the following blood vessels:
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Clinical Effects of Obturator Nerve Injury
You are giving a teaching session to a group of final year medical students regarding lower limb neurology. Which of the following clinical
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Function of the Femoral Nerve
You form part of the trauma team caring for a roofer who fell approximately 7 metres from a roof, landing across a beam. Imaging of the spin
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Contents of the Carpal Tunnel
A patient presents with carpal tunnel syndrome. Which of the following is the most lateral structure in the carpal tunnel:
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Investigation of Hepatitis B Infection
Which of the following serology results is most consistent with acute hepatitis B infection:
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Production of the Thyroid Hormones
Regarding the thyroid hormones, which of the following statements is CORRECT:
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Mechanism of Protein Digestion
Regarding protein digestion, which of the following statements is CORRECT:
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Lesions of the Visual Pathway
What type of visual field defect are you likely to see in a lesion of the temporal optic radiation:
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Control of Bile Release
Which of the following hormones is primarily responsible for release of bile from the gallbladder:
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Clinical Effects of Frontal Lobe Lesion
A 49 year old presents to ED complaining of muscle weakness and clumsiness in the right hand, with slow and effortful speech. In which of th
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Management of Malaria
A 28 year old woman, who is 10 weeks pregnant, is brought to ED with drowsiness and confusion. She has had a persistent fever since recently
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Production of Cerebrospinal Fluid
Cerebrospinal fluid is primarily produced by which of the following structures:
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Nitrates: Side Effects
Which of the following is NOT a typical side effect of glyceryl trinitrate:
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Clinical Effects of Radial Nerve Injury
A 19 year old student fell asleep after a night of drinking with his arm hanging over the back of a chair. He presents to ED complaining of
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Granulomatous Inflammation
Which of the following cytokines is key in maintaining granulomatous inflammation:
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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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Microbial Mechanisms of Attachment
A patient presents with a gastrointestinal infection. Which of the following microbes attaches to gut mucosa via a specialised sucking disc:
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Anatomical vs Alveolar Dead Space
Regarding dead space, which of the following statements is INCORRECT:
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Contents of the Inguinal Canal
Which of the following structures does NOT pass through the inguinal canal:
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Management of Tachyarrhythmias
What is the recommended dosing regime for amiodarone in the treatment of a stable regular broad-complex tachycardia:
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Causes of SIADH
An 82 year old patient presents with muscle weakness, fatigue and nausea. Blood tests demonstrate hyponatraemia. Further tests show low seru
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Types of Statistical Tests
Which of the following statistical tests is most appropriate for comparing means between two independent parametric variables:
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Innervation of the Rectum
Pain from the rectum is carried to which of the following spinal cord levels:
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Generation of an Action Potential
The rising phase of the action potential of a nerve occurs due to which of the following:
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Microbial Mechanisms of Immune Evasion
A patient presenting to ED with sepsis is found to have Staphylococcus aureus bacteremia. Which of the following is a virulence factor of St
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Branches of the Basilar Artery
Which of the following arteries is the terminal branch of the basilar artery:
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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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Iron Deficiency Anaemia
In iron deficiency anaemia, which of the following would you NOT expect to see:
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Pathogenesis of Tetanus
A mother brings her child to ED with a dirty wound sustained at a playground. The patient is due a tetanus booster and you decide to give i
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Production of Insulin
Beta cells of the endocrine pancreas produce which of the following hormones:
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Dermatomal Supply of the Lower Limb
You have been asked to teach a group of medical students about neurological examination of the lower limbs. The L3 dermatome is best tested
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Surface Anatomy of the Kidney
The superior pole of the right kidney reaches as high as which of the following posteriorly:
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Characteristics of the Cutaneous Circulation
Regarding the cutaneous circulation, which of the following statements is CORRECT:
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Pathway of the Gag Reflex
Which of the following nerves is the afferent pathway of the gag reflex:
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C-Reactive Protein
Which of the following cytokines primarily stimulates production of C-reactive protein (CRP):
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Heart Sounds during the Cardiac Cycle
What does the second heart sound correspond to on the ECG waveform:
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Innervation of the Pectineus Muscle
Imaging of a patient who has been involved in a car accident has shown damage to the nerve supplying the pectineus muscle. Which of the foll
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Anatomical Relations of the Kidney
The right kidney is related anteriorly to all of the following structures EXCEPT for the:
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Disease Specific Immunoglobulin: Indications
Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT for:
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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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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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Flumazenil: Indications
Flumazenil is a reversal agent for which of the following groups of drugs:
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Causative Agents of Infective Endocarditis
A patient with known cardiac valve disease presents to ED with fever and shortness of breath worsening over the past 2 weeks. On examination
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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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Clinical Effects of Median Nerve Injury
A 29 year old patient has sustained a laceration to his arm and damaged the nerve that lies medially in the antecubital fossa. What loss of
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