The pancreas is stimulated to release its secretions by

Correct Answer: D

Rationale: The correct answer is D: secretin. Secretin is a hormone released by the duodenum in response to the acidic chyme entering from the stomach. Secretin stimulates the pancreas to release its bicarbonate-rich pancreatic juice to neutralize the acidic chyme. This helps create an optimal pH environment for pancreatic enzymes to function effectively. HCl in chyme (A) is actually the stimulus for secretin release. Trypsinogen (B) is an inactive form of trypsin and is not involved in stimulating pancreatic secretions. Insulin (C) is a hormone produced by the pancreas that regulates blood sugar levels and is not directly involved in stimulating pancreatic secretions.

Correct Answer: A

Rationale: The correct answer is A: A heart rate >100 beats/minute. In the Well's Score for PE, a heart rate >100 indicates a score of 3, reflecting the increased risk of PE. This is because tachycardia can be a sign of the body compensating for decreased oxygen levels due to a PE. Choices B, C, and D are incorrect because they do not register a score of 3 in the Well's Score. Immobilization or surgery within 6 weeks and presence of cancer each score 1 point, while symptoms of haemoptysis score 1 point as well. These factors are important in the overall assessment of PE risk but do not specifically correspond to a score of 3 in the Well's Score system.

Correct Answer: C

Rationale: The most accurate statement is C: "Asthma is associated with breathlessness particularly on lying flat." This is correct because asthma symptoms often worsen when lying flat due to increased pressure on the chest and airways. Option A is incorrect because a long-acting beta2-agonist is not recommended for mild intermittent asthma as it is a step-up therapy for persistent asthma. Option B is incorrect as chronic productive cough is more commonly associated with conditions like chronic bronchitis. Option D is incorrect because a reversibility of <10% in FEV1 is not consistent with a diagnosis of asthma, as asthma typically shows significant reversibility in lung function tests.

Correct Answer: A

Rationale: Rationale: 1. Fasting plasma glucose >=7.0 mmol/l is a diagnostic criteria for diabetes. 2. It indicates sustained hyperglycaemia without food intake influencing the result. 3. Choice B tests glucose response to a glucose challenge and may not reflect fasting levels. 4. HbA1c measures average glucose levels over 2-3 months, not immediate status. 5. Choice D lacks specificity as random glucose levels can fluctuate.

Correct Answer: B

Rationale: The correct answer is B. Lowering blood pressure and urgent CT angiogram are crucial in suspected aortic dissection. High BP with variability between arms and tearing chest pain are classic signs. T-wave inversions in inferior leads may occur but are not specific to aortic dissection. Choice A is incorrect as antibiotics are not indicated unless infective endocarditis is confirmed. Choice C is incorrect as antiplatelet therapy and heparin are not first-line treatments for aortic dissection. Choice D is incorrect as NSAIDs can worsen aortic dissection, and echocardiogram is not the initial imaging modality of choice for this condition.