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Saginata b) T. 7 kPa b) Is seen in early stages of severe asthma c) Can be caused by ventilation/perfusion mismatch d) Is treated by increasing the FiO2 9 In a child with a fever a) Ideally, both paracetamol and ibuprofen should be given together to reduce the temperature as they act synergistically b) For suspected meningococcal septicaemia, cefotaxime is the preferred antibiotic c) It is important to get blood cultures as soon as possible d) For a suspected urinary tract infection, the urine should be obtained using urine bags 10 Investigations for suspected TB include a) Biopsies of solid lesions and lymph nodes b) Gastric washings subjected to staining and culture c) Chest X-ray d) Sputum culture in Ziehl–Nielsen medium 54 Practice Paper 6 CHAPTER 6 11 Osteomyelitis a) Is never caused by fungi, viruses and other parasites b) Is an infection of the cortex of a bone c) Is common in children due to haemophilus d) May originate from a small lesion such as a boil on the skin 12 At the shoulder joint a) The deltoid muscle initiates abduction b) The subacromial bursa does not communicate with the articular cavity c) The teres minor and teres major muscles form a part of the rotator cuff d) Anterior dislocations may lead to a radial nerve palsy 13 The autonomic nervous system a) Differs from the cerebrospinal nervous system by having the course of its efferent nerves interrupted by a synapse in a peripheral ganglion b) Has its sympathetic motor cells in the anterior grey columns of all the thoracic and upper two lumbar segments c) Has its cranial parasympathetic outflow along cranial nerves III, VIII, IX and X d) All sympathetic postganglionic terminals release adrenaline and noradrenaline 14 About chronic granulocytic leukaemia a) The platelet count can be normal to high b) Philadelphia chromosome is present in the neoplastic cells c) Blast crisis is more common in chronic lymphocytic leukaemia d) Splenomegaly is common 15 Causes of polycythaemia include a) Non-neoplastic kidney disease b) Chronic pulmonary disease c) High altitude d) Benign familial polycythaemia 16 Regarding immunodeficiencies a) In DiGeorge’s syndrome, B cells and immunoglobulin levels are usually normal b) Wiskott–Aldrich syndrome is characterised by thrombocytopenia, eczema and recurrent infections 55 CHAPTER 6 Practice Paper 6 c) X-linked agammaglobulinaemia starts presenting at 8–9 months of age d) CD8+ helper T-cell depletion is central to the pathogenesis of AIDS 17 Cortisol a) Increases the quantity of protein in most tissues in the body b) Has its main function to increase resistance of the body to any physical stress c) Depresses utilisation of glucose by tissues d) Stabilises lysosomal membranes 18 With somaesthetic sensation there are several specialised tactile receptors a) The pacinian corpuscle is quite superficial in tissues and responds to rapid tissue deformation b) The meissner corpuscle is found in the toes and enables us to discriminate very precise texture and fine details of objects touched c) Krause’s corpuscles are located in the sexual organs and are responsible for some sexual sensations d) Ruffini’s end-organ detects stretch of tissues and joints allowing determination of the degree of angulation of the joint 19 Refractory shock a) Can occur only with haemorrhagic shock b) Causes damage to the gastrointestinal mucosa allowing bacteria to enter the circulation c) Is a state when there is no longer any response to vasopressors despite correcting the blood volume d) Is contributed to by negative feedback mechanisms of the CNS 20 Regarding infections with Salmonella a) S.

7 kPa b) Is seen in early stages of severe asthma c) Can be caused by ventilation/perfusion mismatch d) Is treated by increasing the FiO2 9 In a child with a fever a) Ideally, both paracetamol and ibuprofen should be given together to reduce the temperature as they act synergistically b) For suspected meningococcal septicaemia, cefotaxime is the preferred antibiotic c) It is important to get blood cultures as soon as possible d) For a suspected urinary tract infection, the urine should be obtained using urine bags 10 Investigations for suspected TB include a) Biopsies of solid lesions and lymph nodes b) Gastric washings subjected to staining and culture c) Chest X-ray d) Sputum culture in Ziehl–Nielsen medium 54 Practice Paper 6 CHAPTER 6 11 Osteomyelitis a) Is never caused by fungi, viruses and other parasites b) Is an infection of the cortex of a bone c) Is common in children due to haemophilus d) May originate from a small lesion such as a boil on the skin 12 At the shoulder joint a) The deltoid muscle initiates abduction b) The subacromial bursa does not communicate with the articular cavity c) The teres minor and teres major muscles form a part of the rotator cuff d) Anterior dislocations may lead to a radial nerve palsy 13 The autonomic nervous system a) Differs from the cerebrospinal nervous system by having the course of its efferent nerves interrupted by a synapse in a peripheral ganglion b) Has its sympathetic motor cells in the anterior grey columns of all the thoracic and upper two lumbar segments c) Has its cranial parasympathetic outflow along cranial nerves III, VIII, IX and X d) All sympathetic postganglionic terminals release adrenaline and noradrenaline 14 About chronic granulocytic leukaemia a) The platelet count can be normal to high b) Philadelphia chromosome is present in the neoplastic cells c) Blast crisis is more common in chronic lymphocytic leukaemia d) Splenomegaly is common 15 Causes of polycythaemia include a) Non-neoplastic kidney disease b) Chronic pulmonary disease c) High altitude d) Benign familial polycythaemia 16 Regarding immunodeficiencies a) In DiGeorge’s syndrome, B cells and immunoglobulin levels are usually normal b) Wiskott–Aldrich syndrome is characterised by thrombocytopenia, eczema and recurrent infections 55 CHAPTER 6 Practice Paper 6 c) X-linked agammaglobulinaemia starts presenting at 8–9 months of age d) CD8+ helper T-cell depletion is central to the pathogenesis of AIDS 17 Cortisol a) Increases the quantity of protein in most tissues in the body b) Has its main function to increase resistance of the body to any physical stress c) Depresses utilisation of glucose by tissues d) Stabilises lysosomal membranes 18 With somaesthetic sensation there are several specialised tactile receptors a) The pacinian corpuscle is quite superficial in tissues and responds to rapid tissue deformation b) The meissner corpuscle is found in the toes and enables us to discriminate very precise texture and fine details of objects touched c) Krause’s corpuscles are located in the sexual organs and are responsible for some sexual sensations d) Ruffini’s end-organ detects stretch of tissues and joints allowing determination of the degree of angulation of the joint 19 Refractory shock a) Can occur only with haemorrhagic shock b) Causes damage to the gastrointestinal mucosa allowing bacteria to enter the circulation c) Is a state when there is no longer any response to vasopressors despite correcting the blood volume d) Is contributed to by negative feedback mechanisms of the CNS 20 Regarding infections with Salmonella a) S.

4% sodium bicarbonate contains 1000 mmol/L of sodium c) Primary hyperaldosteronism causes hyponatraemia d) Urine osmolality is always very high in hypernatraemic patients 10 Regarding oxygen transport a) 5% of oxygen in the blood is carried in the dissolved state b) Fever reduces the affinity of haemoglobin to oxygen 44 Practice Paper 5 CHAPTER 5 c) Increase in 2,3 DPG shifts the oxyhaemoglobin dissociation curve to the right d) Metabolic alkalosis reduces the affinity of haemoglobin to oxygen 11 Chlamydial infection a) Causes an increased risk of cervical cancer in women b) May present as right upper quadrant pain in men due to perihepatitis and called Fitz-Hugh and Curtis syndrome c) Is confirmed by cell culture and has a high sensitivity and rarely has false-negative results d) Should be treated with azithromycin or doxycycline 12 Regarding the scalp a) The auriculotemporal nerve supplies the scalp posterior to the ear b) The aponeurotic layer includes the occipitofrontalis muscle c) The superficial temporal artery supplying the scalp is a branch of the external carotid artery d) Bleeding from scalp lacerations is usually self-limiting 13 The posterior mediastinum a) Is continuous through the superior mediastinum with the neck b) Is traversed by the deep cardiac plexus of nerves c) Can be involved in neck infections spreading between the pretracheal and prevertebral fasciae d) Extends posteriorly down to T10 vertebra level 14 Cerebrospinal fluid a) Has more protein compared with plasma b) Raised intracranial pressure is a contraindication for performing a lumbar puncture c) Normal glucose level is Ͼ60% of blood level d) Shows predominantly lymphocytes in viral meningitis 15 Biomechanics a) Is concerned with the internal and external forces acting on the body b) When abnormal can lead to chronic injuries c) Should be considered in patellofemoral syndrome d) Also, deals with work energy and power 45 CHAPTER 5 Practice Paper 5 16 Ketamine a) Is a phencyclidine derivative and binds to GABA receptors b) Provides substantial analgesia and can be administered intramuscularly c) Increases arterial pressure by 25% but reduces intracranial pressure d) Can cause nightmares especially in children 17 Anticholinergic inhaled agents a) Work by inhibiting the bronchoconstriction caused by stimulation of the vagus nerve b) Reduce secretion of mucus c) Ipratropium bromide is a derivative of atropine d) Inhibit the rise in intracellular cyclic AMP 18 The cardiac output is determined by a) Blood volume b) Blood flow to cardiac muscle c) Stroke volume d) Heart rate 19 Which of the following occur in haemorrhagic shock?