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Date Completed: 21/04/2024
Page 1 of 18
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Causative Agents of Neonatal Meningitis
A one week old infant is brought to ED unwell. She is pyrexic, floppy and unresponsive with a bulging fontanelle. Empirical antibiotics are
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Anatomical Factors Guarding Against Gastric Reflex
Which of the following is NOT an anatomical feature that prevents against gastric reflux:
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Routine Immunisation Schedule
Regarding the routine childhood immunisation schedule, which of the following vaccines is given to preschool children (aged 3 years and 4 mo
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Management of Anaphylaxis
A patient presents to ED with itching and swollen lips. He is known to be allergic to nuts. He receives adrenaline but there is no improveme
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Causative Agents of Ophthalmia Neonatorum
A full term 6 day old neonate is brought in with a unilateral eye purulent discharge which the parents noticed earlier that day. On gram sta
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Borders of the Heart
The right border of the heart is formed predominantly by which of the following:
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Surface Anatomy of the Heart
The lower limit of the heart on the right side of the sternum is the:
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Proton Pump Inhibitors: Pharmacology
Regarding proton pump inhibitors, which of the following statements is CORRECT:
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Structure of the Sympathetic Nervous System
Regarding the sympathetic nervous system, which of the following statements is CORRECT:
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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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Clinical Features of Hepatitis C Infection
Regarding hepatitis C, which of the following statements is CORRECT:
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Microbial Mechanisms of Immune Evasion
Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis all colonise the upper respiratory tract and can spread from the
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Renal Handling of Sodium
About what percentage of filtered Na+ is reabsorbed in the loop of Henle:
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Function of the Orbicularis Oculi Muscle
The orbicularis oculi muscle is responsible for which of the following:
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Regulation of Iron Metabolism
Regarding iron metabolism, which of the following statements is CORRECT:
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Structure of the Inguinal Canal
Regarding the inguinal canal, which of the following statements is CORRECT:
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Mechanism of Postural Hypotension
Regarding postural hypotension, which of the following statements is INCORRECT:
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Blood Supply of the Visual Pathway
The extracranial portion of the optic nerve is supplied by which of the following blood vessels:
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Function of the Proximal Tubule
Regarding the proximal tubule, which of the following statements is CORRECT:
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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 Campylobacter Jejuni
Campylobacter jejuni is primarily spread via which of the following routes:
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Lobes of the Liver
The quadrate and caudate lobes of the liver are separated by which of the following structures:
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Origin of the Superficial Temporal Artery
The superficial temporal artery is a branch of which of the following blood vessels:
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Calculation of Median
What is the median of the following data set; 3, 13, 7, 5, 21, 24, 23, 40, 25, 21, 12, 56, 26, 29, 39
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Production of Intrinsic Factor
Intrinsic factor is secreted by which of the following cell types in the stomach:
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Trimethoprim: Side Effects
Which of the following side effects is most likely attributed to trimethoprim:
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Definition of Lung Volumes and Capacities
Which of the following describes the volume of air that can be inspired at the end of a resting inspiration:
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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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Intraperitoneal vs Retroperitoneal Organs
Which of the following structures is NOT retroperitoneal:
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Clinical Features of Hypothyroidism
Which of the following clinical features is NOT typical of hypothyroidism:
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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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Innervation of the Pharynx
The sensory innervation of the nasopharynx is provided by which of the following nerves:
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Surface Anatomy of the Heart Valves
Which of the following best describes the surface marking of the tricuspid valve:
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Definition of Correlation Coefficient
Regarding correlation, which of the following statements is CORRECT:
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Antipsychotics: Side Effects
Neuroleptic malignant syndrome is characterised by all EXCEPT which one of the following:
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NSAIDs: Side Effects
A 25 year old woman presents to ED because she has noticed her skin seems to have a yellow tinge. On examination she has jaundice and mild s
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Dermatomal Supply of the Lower Limb
The L5 dermatome is best tested at which of the following landmarks:
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Clinical Effects of Ulnar Nerve Injury
A 58 year old man sustains an injury to the ulnar nerve and complains of sensory loss. Which of the following areas of skin would you LEAST
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Content of Bile
A patient presents with gallstones likely due to an imbalance in the chemical make-up of bile inside the gallbladder. What is the main compo
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ALS Treatment Algorithm
In adult basic life support, chest compressions and breaths should be given in which of the following ratios:
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Action Potential of the Ventricular Myocyte
In the ventricular myocyte action potential, the plateau phase of the action potential occurs due to a:
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Mechanism of Postural Hypotension
What is the initial physiological effect resulting in postural hypotension:
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Nitrates: Side Effects
Which of the following is NOT a typical side effect of glyceryl trinitrate:
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Control of Gastric Emptying
Regarding gastric motility and emptying, which of the following statements is CORRECT:
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Assessment of the Rotator Cuff Muscles
A patient presents following a shoulder injury. You suspect a rotator cuff tear and are assessing the function of the rotator cuff muscles.
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Beta-2 Agonists: Pharmacology
Regarding selective beta-2 agonists, which of the following statements is INCORRECT:
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Function of the Temporalis Muscle
The temporalis muscle acts to produce which of the following movements:
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JVP Waveforms during the Cardiac Cycle
Which of the following JVP waveforms corresponds with isovolumetric contraction:
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Calculation of Absolute Risk Reduction
A randomised controlled trial (RCT) is performed where 1000 men are treated with a lipid-lowering drug, Superstatin, and 1000 given a placeb
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Disseminated Intravascular Coagulation
Which of the following laboratory findings is NOT typical of disseminated intravascular coagulation (DIC):
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Surface Anatomy of the Spinal Cord
In adults, the conus medullaris of the spinal cord lies at which of the following vertebral levels:
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Cutaneous Innervation of the Upper Limb
A 35 year old woman has undergone a total mastectomy for breast cancer. Postoperatively she complains of loss of sensation in the inner aspe
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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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Anatomical Relations of the Spleen
A 19 year old male is brought to ED having sustained a handlebar injury with blunt trauma to his upper abdomen whilst riding his scooter. Wh
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Phases of the Cardiac Cycle
Regarding the cardiac cycle, which of the following statements is CORRECT:
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Phases of Swallowing
During swallowing, the nasopharynx is closed off by which of the following structures:
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Disturbance of Acid-Base Balance
You review a patient in ED who has taken an aspirin overdose. Which of the following patterns best describes the following arterial blood ga
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Cortical Areas of the Frontal Lobe
The primary motor cortex is located in which of the following regions:
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Attachment Mechanisms of Neisseria Gonorrhoeae
A patient presents to ED complaining of a purulent discharge, urethral discomfort and dysuria. You suspect gonorrhoea. Which of the followi
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Clinical Effects of Trochlear Nerve Lesion
A patient complains of a vertical diplopia, worse on reading or walking downstairs. Which of the following cranial nerves is most likely to
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Complications of Mumps
Which of the following is NOT a typical complication associated with mumps:
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Transmission of Herpes Simplex
Herpes simplex virus is transmitted most commonly through which of the following routes:
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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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Function of the Renin-Angiotensin-Aldosterone System
Regarding the renin-angiotensin-aldosterone system (RAAS), which of the following statements is CORRECT:
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Mechanism of Synaptic Transmission
Neurotransmitter release from the presynaptic membrane is triggered by:
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Clinical Effects of Ulnar Nerve Injury
A 54 year old lady presents to ED having injured her left arm. She is complaining of weak hand grip of her left hand. The patient is unable
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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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Calculation of the Anion Gap
Which of the following cations are required to calculate the anion gap:
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Products of Cellular Respiration
What is the net production of ATP molecules formed during anaerobic respiration:
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Function of Gastric Acid
Gastric hydrochloric acid performs all of the following functions EXCEPT for:
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Function of Lung Receptors
Regarding pulmonary receptors, which of the following statements is CORRECT:
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Routine Immunisation Schedule
Measles, mumps and rubella (MMR) vaccine is given at which of the following intervals in the UK routine childhood immunisation schedule:
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Ligaments of the Knee Joint
A 30 year old male was hit by a car in his lateral knee joint region. His knee was in extension when struck. Which of the following structur
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Fibrinolytics: Pharmacology
Regarding fibrinolytics, which of the following statements is INCORRECT:
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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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Dobutamine: Mechanism of Action
What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:
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Clinical Features of Primary Adrenal Insufficiency
A 46 year old woman complains of feeling lethargic and dizzy on standing. On examination you note darkening of her lips and gums. Blood test
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Blood Supply of the Pancreas
The blood supply to the pancreas is primarily from which of the following arteries:
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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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Causative Agents of Osteomyelitis
A 45 year old man presented with fever and upper back pain. MRI imaging demonstrated inflammation of the T8 - T9 vertebral bodies consistent
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Interpretation of Base Excess
A high (positive) base excess is typically seen in which of the following:
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Flumazenil: Indications
Flumazenil is a reversal agent for which of the following groups of drugs:
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Control of Exocrine Pancreas Secretion
Digestive enzymes are secreted from which cell type in the pancreas:
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Anatomy of the Trochlear Nerve
Regarding the trochlear nerve, which of the following statements is CORRECT:
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Contents of the Rectus Sheath
A patient presents with a superficial stab wound to the rectus sheath. Which of the following muscles is contained within the rectus sheath:
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Roots of the Pterygopalatine Ganglion
A 28 year old woman complains of dryness of the nose and the palate. A lesion is most likely affecting which of the following ganglia:
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Anatomy of the Thyroid Gland
Regarding the thyroid gland, which of the following statements is INCORRECT:
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Increased vs Normal Anion Gap
Which of the following is typically a cause of an increased anion gap metabolic acidosis:
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Management of Atrial Fibrillation
A 70 year old man is brought to ED by ambulance with sudden onset chest pain, palpitations and shortness of breath. His HR is 160 bpm and BP
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Attachments of the Psoas Major Muscle
The psoas major muscle attaches distally to which of the following:
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Lesions of the Visual Pathway
Which of the following is most likely to cause a homonymous hemianopia:
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Measuring Spread using Standard Deviation
A group of patients enrolling for a trial had a normal distribution for weight. The mean weight of the patients was 80 kg. The standard devi
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Infectious Disease caused by Legionella Pneumophila
Regarding Legionellosis, which of the following statements is CORRECT:
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Aspirin: Contraindications
Which of the following is NOT a contraindication to treatment with aspirin at analgesic doses:
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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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Renal Handling of Phosphate
Regarding renal phosphate handling, which of the following statements is CORRECT:
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Mechanism of Cardiac Excitation-Contraction Coupling
Intracellular [Ca2+] rise in cardiac excitation-contraction coupling is mainly as a result of:
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Lesions of the Visual Pathway
A patient presents complaining of visual loss. On examination you note a contralateral homonymous hemianopia. Where is the most likely site
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Lymphatic Drainage of the Testis
A 21 year old man presents to ED complaining of a scrotal lump. Imaging demonstrates a testicular tumour. The lymphatic drainage of the test
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Surface Anatomy of the Trachea
The trachea arises at the lower border of the cricoid cartilage in the neck at which vertebral level:
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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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Thiazide Diuretics: Side Effects
Bendoflumethiazide may cause all of the following electrolyte imbalances EXCEPT for:
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ALS Treatment Algorithm
In adult advanced life support, what is the correct initial dose of amiodarone for a shockable rhythm:
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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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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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Action Potential of the Ventricular Myocyte
In ventricular myocytes, the plateau phase of the action potential comes about through which of the following:
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Fibres of the Internal Capsule
The internal capsule primarily contains which types of white matter fibres:
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Cutaneous Innervation of the Face
The skin of the lower lip and chin is primarily supplied by which of the following nerves:
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Haemolytic Anaemia
Which of the following clinical features is a feature of a chronic extravascular haemolytic anaemia:
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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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Characteristics of the Skeletal Muscle Circulation
Regarding the skeletal muscle circulation, which of the following statements is CORRECT:
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Calculation of Positive Likelihood Ratio
The results from the study investigating the accuracy of a new diagnostic test can be displayed in the following format. How is the positi
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Mechanism of the Baroreceptor Reflex
Arterial baroreceptors primarily detect which of the following:
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Haemophilia
Regarding the inheritance of haemophilia A (and assuming the other parent is a non-carrier), which of the following statements is CORRECT:
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Function of the Na-K ATPase Pump
Regarding the Na+/K+ ATPase pump, which of the following statements is INCORRECT:
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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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Functional Anatomy of the Pituitary Gland
Which of the following statements regarding the pituitary gland is CORRECT:
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Anatomical Relations of the Pancreas
A 49 year old man presents to ED with a few months history of abdominal pain and weight loss. Imaging shows a tumour in the uncinate process
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Function of Parathyroid Hormone
What is the net effect of parathyroid hormone (PTH) on the gastrointestinal system through both its direct and indirect actions:
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Structure of the Lymphatic System
Regarding the lymphatic system, which of the following statements is CORRECT:
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Supply of the Femoral Artery
A 32 year old man presents to the ED after falling through a glass door. He has sustained a deep laceration to the thigh. Imaging shows a so
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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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Risk Factors for Herpes Simplex Infection
Which patients are particularly susceptible to infection with herpes simplex, those with:
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Antimuscarinic Drugs: Contraindications
You wish to prescribe an antimuscarinic drug to your patient. Which of the following is a contraindication:
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Anatomical Location of the Pituitary Gland
Regarding the position of the pituitary gland, which of the following statements is CORRECT:
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Hypersensitivity Reactions
On your medical elective, a HIV positive intravenous drug user is suspected of having active tuberculosis, and a tuberculin (Mantoux) intrad
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Function of the Psoas Major Muscle
The psoas major muscles acts to produce which of the following movements:
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Factors affecting Lung Compliance
Regarding compliance, which of the following statements is CORRECT:
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Layers of the Neck Fascia
Regarding the neck fascia, which of the following statements is CORRECT:
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Relative Ionic Distribution in Fluid Spaces
Which of the following ions normally has the highest concentration in intracellular fluid:
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Anatomical Location of the Pituitary Gland
The pituitary gland sits within a small depression in which of the following skull bones:
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Recruitment of Motor Units
Regarding graded muscle contraction, which of the following statements is INCORRECT:
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Attachments of the Temporalis Muscle
The temporalis muscles inserts onto which of the following structures:
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Cutaneous Innervation of the Face
A 49 year old man complains of pain and tingling over his chin and lower lip, which later developed into a vesicular rash. You diagnose shin
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Measurement of Lung Volumes and Capacities
Which of the following can NOT be measured from the trace produced when a subject breathes in and out of a simple spirometer:
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Surface Anatomy of the Larynx
The larynx blends inferiorly with the trachea at which of the following vertebral levels:
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Surface Anatomy of the Appendix
McBurney's point, the surface projection of the base of the appendix is located at which of the following sites:
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Sickle Cell Disease
The sickle cell trait has a protective advantage against which of the following infections:
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Lymphatic Drainage of the Lower Limb
A 54 year old woman presents with unilateral swelling of the left leg. Her d-dimer is normal and ultrasound has shown no demonstrable deep v
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Homeostasis and Feedback Loops
Regarding homeostasis, which of the following statements is CORRECT:
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Clinical Features of Croup
A 3 year old child is brought into ED with fever, a barking cough and difficulty breathing. On examination you note inspiratory stridor, tac
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Function of Atrial Natriuretic Peptide
Atrial natriuretic peptide (ANP) acts to cause all of the following effects EXCEPT for:
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Clinical Features of Hepatitis A Infection
About what percentage of patients with hepatitis A develop chronic infection:
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Homeostasis and Feedback Loops
Regarding homeostasis, which one of the following statements is CORRECT:
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Innervation of the Subscapularis Muscle
You are asked to review a 54 year old man who presents with isolated weakness of the right shoulder. On examination you note the patient is
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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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Structure of the Vocal Ligament
The vocal ligament is formed by which of the following structures:
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Muscle Relaxants: Pharmacology
Regarding muscle relaxant drugs, which of the following statements is CORRECT:
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Dermatomal Supply of the Lower Limb
The S2 dermatome is best tested at which of the following landmarks:
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Chronic Immune Thrombocytopaenic Purpura
Regarding chronic immune thrombocytopaenic purpura (ITP), which of the following statements is INCORRECT:
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Heart Sounds during the Cardiac Cycle
A 60 year old man presents with chest pain. On examination you note a fourth heart sound. What does the fourth heart sound correspond with:
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