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  • Question 1 - What is the enzyme that is involved in the formation of citrulline? ...

    Correct

    • What is the enzyme that is involved in the formation of citrulline?

      Your Answer: Ornithine transcarbamoylase

      Explanation:

      Carbamoyl phosphate is converted to citrulline by ornithine transcarbamoylase.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      1.5
      Seconds
  • Question 2 - During anaerobic glycolysis, the net production of ATP is: ...

    Correct

    • During anaerobic glycolysis, the net production of ATP is:

      Your Answer: 2

      Explanation:

      Anaerobic glycolysis is the transformation of glucose to lactate when limited amounts of oxygen (O2) are available. Anaerobic glycolysis is only an effective means of energy production during short, intense exercise, providing energy for a period ranging from 10 seconds to 2 minutes. It produces 2 ATP molecules per glucose molecule.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      1.3
      Seconds
  • Question 3 - The pyloric sphincter is largely made up of thickening of ...

    Incorrect

    • The pyloric sphincter is largely made up of thickening of

      Your Answer: The oblique muscle layer

      Correct Answer: The circular muscle layer

      Explanation:

      The pyloric sphincter, or valve, is a strong ring of smooth muscle (circular muscle layer) at the end of the pyloric canal which lets food pass from the stomach to the duodenum. It controls the outflow of gastric contents into the duodenum. It receives sympathetic innervation from the celiac ganglion.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      3.1
      Seconds
  • Question 4 - Which of the following is the smallest cell of the nervous system? ...

    Incorrect

    • Which of the following is the smallest cell of the nervous system?

      Your Answer:

      Correct Answer: Microglia

      Explanation:

      Microglia are the smallest of the neuroglial cells in the nervous system. They are scattered throughout the central nervous system and have phagocytic properties.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds
  • Question 5 - Intermediate filaments achieve cell to cell contact via: ...

    Incorrect

    • Intermediate filaments achieve cell to cell contact via:

      Your Answer:

      Correct Answer: Desmosomes

      Explanation:

      At the plasma membrane, some keratins interact with desmosomes (cell-cell adhesion) and hemidesmosomes (cell-matrix adhesion) via adapter proteins.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds
  • Question 6 - A 68 year old man presents with acute symptoms of gout on his...

    Incorrect

    • A 68 year old man presents with acute symptoms of gout on his first metatarsophalangeal joint. Which option best explains the underlying mechanism of gout?

      Your Answer:

      Correct Answer: Decreased renal excretion of uric acid

      Explanation:

      Primary gout is related more often to underexcretion of uric acid or overproduction.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds
  • Question 7 - A 50-year-old woman under treatment for manic-depressive psychosis presents in an unconscious state...

    Incorrect

    • A 50-year-old woman under treatment for manic-depressive psychosis presents in an unconscious state after an episode of seizure on the street. Her husband who accompanied her into the ER reported that they argued about 6-7 hours ago. On examination, she is found to be hypertonic with a GCS of 8, BP: 90/60 mmHg and a pulse of 105 bpm. Blood investigations revealed a lithium level of 3.2 mmol/L. She was intubated and ventilated. Which of the following is the most appropriate immediate management in this case?

      Your Answer:

      Correct Answer: N saline should be started iv

      Explanation:
      1. Normal saline (N saline) should be started IV: Intravenous normal saline is recommended to enhance renal excretion of lithium. Adequate hydration is crucial because lithium is primarily excreted by the kidneys, and maintaining good urine output can help reduce lithium levels.
      2. Dialysis: This is considered the most effective treatment for severe lithium toxicity, especially when serum levels are significantly elevated (typically >2.5 mmol/L) and the patient presents with severe symptoms such as seizures, altered mental status, or renal impairment. Given the patient’s lithium level of 3.2 mmol/L and her critical condition, dialysis is necessary to rapidly reduce lithium levels.

      The other options are less appropriate or ineffective in this context:

      • Gastric lavage should be considered: This is not typically recommended for lithium poisoning because lithium is rapidly absorbed and lavage is unlikely to be effective several hours post-ingestion.
      • Activated charcoal is likely to be effective: Activated charcoal does not effectively bind lithium and is not recommended for lithium poisoning.
      • 5% dextrose should be started IV: While maintaining hydration is important, normal saline is preferred over dextrose solutions in this context to promote renal excretion of lithium.
      • Dialysis is not normally required unless levels are above 5 mmol/L: This statement is incorrect. Dialysis is often required at lower levels, particularly in cases of severe toxicity or if the patient is symptomatic, as seen in this case.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds
  • Question 8 - The branche(s) of the left coronary artery include: ...

    Incorrect

    • The branche(s) of the left coronary artery include:

      Your Answer:

      Correct Answer: Left circumflex artery & anterior interventricular artery

      Explanation:

      The left main coronary divides into branches:

      1. The left anterior descending artery branches off the left coronary artery and supplies blood to the front of the left side of the heart.

      2. The circumflex artery branches off the left coronary artery and encircles the heart muscle.

      The anterior interventricular artery is otherwise known as the anterior descending branch. The posterior descending artery comes from Right coronary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 9 - Which of the following derivatives of proopiomelanocortin is an opioid peptide? ...

    Incorrect

    • Which of the following derivatives of proopiomelanocortin is an opioid peptide?

      Your Answer:

      Correct Answer: ß-endorphin

      Explanation:

      ß-endorphin is an endogenous opioid neuropeptide which is mainly synthesized and stored in the anterior pituitary gland, derived from the precursor proopiomelanocortin (POMC). Some studies have shown that immune system cells are also capable of synthesizing ß-endorphin. β-endorphin is thought to exert a tonic inhibitory influence upon GNRH secretion and to be an important regulator of reproductive function.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds
  • Question 10 - β-blockers are used in the treatment of angina because they have which one...

    Incorrect

    • β-blockers are used in the treatment of angina because they have which one of the following properties?

      Your Answer:

      Correct Answer: Decrease the heart rate and myocardial contractility

      Explanation:

      The cardiovascular effects of β-adrenoceptor block result from reduction of the sympathetic drive which includes reduced heart rate (automaticity) and reduced myocardial contractility (rate of rise of pressure in the ventricle). This will lead to reduced cardiac output and an overall fall in oxygen consumption.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds
  • Question 11 - Bile salts are responsible for: ...

    Incorrect

    • Bile salts are responsible for:

      Your Answer:

      Correct Answer: The emulsification of fats

      Explanation:

      The main function of bile acids is to allow digestion of dietary fats and oils by acting as a surfactant that emulsifies them into micelles, allowing them to be colloidally suspended in the chyme before further processing.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds
  • Question 12 - Emulsification of dietary lipids is brought about by ...

    Incorrect

    • Emulsification of dietary lipids is brought about by

      Your Answer:

      Correct Answer: Bile salts

      Explanation:

      Digestion of fats can begin in the mouth where lingual lipase breaks down some short chain lipids into diglycerides. However fats are mainly digested in the small intestine. The presence of fat in the small intestine produces hormones that stimulate the release of pancreatic lipase from the pancreas and bile from the liver which helps in the emulsification of fats for absorption of fatty acids.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds
  • Question 13 - In a newly diagnosed acromegaly patient, which of the following would you not...

    Incorrect

    • In a newly diagnosed acromegaly patient, which of the following would you not expect to find?

      Your Answer:

      Correct Answer: Hypohidrosis

      Explanation:

      Features of acromegaly may include:

      • Soft tissue swelling visibly resulting in enlargement of the hands, feet, nose, lips and ears, and a general thickening of the skin
      • Soft tissue swelling of internal organs, notably the heart with associated weakening of its muscularity, and the kidneys, vocal cords (resulting in a characteristic thick, deep voice and slowing of speech)
      • Generalized expansion of the skull at the fontanelle, frontal bossing, prognathism with associated macroglossia (enlargement of the tongue) and teeth spacing.
      • Hypertrichosis, hyperpigmentation and hyperhidrosis (not hypohidrosis) may occur in these patients as well as carpal tunnel syndrome and impotence.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds
  • Question 14 - When looking at the JVP what does the c wave signify: ...

    Incorrect

    • When looking at the JVP what does the c wave signify:

      Your Answer:

      Correct Answer: Isovolumetric ventricular contraction

      Explanation:

      The C wave signifies a rise in the atrial pressure during isovolumetric contraction due to the tricuspid valve bulging into the atria.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 15 - Which of the following stimulates glucagon release? ...

    Incorrect

    • Which of the following stimulates glucagon release?

      Your Answer:

      Correct Answer: Exercise

      Explanation:

      Studies have shown a small increase in glucagon levels during stress tests and exercise. This occurs in response to the reduction of blood glucose levels during physical activity; epinephrine levels are also a stimulus for the release of glucagon during exercise, since it suppresses insulin, which accounts for its stimulatory effects on glucagon. The use of stored fats for energy during exercise also stimulates the release of glucagon.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds
  • Question 16 - The first enzyme carbohydrates encounter in the digestive tract is? ...

    Incorrect

    • The first enzyme carbohydrates encounter in the digestive tract is?

      Your Answer:

      Correct Answer: Amylase

      Explanation:

      Carbohydrate digesting enzymes are known as amylase. Salivary amylase or ptyalin is the first enzyme to begin carbohydrate digestion in he oral cavity. Amylose is a component of carbohydrates and is not an enzyme. Isomaltase, maltase and sucrase are enzymes found in the small intestines that digest disaccharides like maltose and sucrose to monosaccharides.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds
  • Question 17 - Which of the following conditions is procoagulant? ...

    Incorrect

    • Which of the following conditions is procoagulant?

      Your Answer:

      Correct Answer: Factor V Leiden

      Explanation:

      Factor V Leiden is a genetic mutation of one of the clotting factors in the blood, Factor V. This mutation makes Factor V resistant to inactivation by activated Protein C, which normally helps to regulate clot formation. As a result, individuals with Factor V Leiden are at increased risk of developing abnormal blood clots (thrombophilia), making it a procoagulant condition.

      The other conditions listed are associated with bleeding tendencies rather than increased clotting:

      • Afibrinogenemia: A rare genetic disorder where there is a complete lack of fibrinogen, leading to bleeding problems.
      • Hemophilia: A group of inherited bleeding disorders where blood does not clot properly due to the lack of sufficient blood-clotting proteins (factors VIII or IX).
      • Hypothrombinemia: A condition characterized by low levels of prothrombin, leading to increased bleeding.
      • Christmas disease (Hemophilia B): A form of hemophilia caused by a deficiency of factor IX, resulting in a bleeding tendency.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds
  • Question 18 - The enzyme responsible for Telomeres to maintain their length after cell division is...

    Incorrect

    • The enzyme responsible for Telomeres to maintain their length after cell division is called:

      Your Answer:

      Correct Answer: Telomerase reverse transcriptase

      Explanation:

      Telomeres are non-coding DNA consisting of repetitive nucleotide sequences plus proteins that are found at the end of the linear chromosomes. They maintain the integrity of the chromosomes and prevent their shortening.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds
  • Question 19 - Which glucose transporter is responsible for the uptake of glucose in ß cells?...

    Incorrect

    • Which glucose transporter is responsible for the uptake of glucose in ß cells?

      Your Answer:

      Correct Answer: GLUT 2

      Explanation:

      Glucose transporter 2, also known as GLUT2 is a transmembrane carrier protein which is not insulin dependent. It is found in the liver and the pancreatic islet ß cells, where it functions as the primary glucose transporter that allows the transfer of glucose between these organs and blood.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds
  • Question 20 - Regarding bronchial innervation which of the following is correct: ...

    Incorrect

    • Regarding bronchial innervation which of the following is correct:

      Your Answer:

      Correct Answer: Alpha 1 receptors increase bronchial constriction

      Explanation:

      Stimulation of β2 receptors results in smooth muscle relaxation and bronchodilation. α1 receptors cause smooth muscle contraction in the bronchioles although minor to the β2 effects.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      0
      Seconds
  • Question 21 - The following is true in relation to coronary venous drainage? ...

    Incorrect

    • The following is true in relation to coronary venous drainage?

      Your Answer:

      Correct Answer: Most venous return ultimately drains into right atrium via the coronary sinus

      Explanation:

      Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins. Apart from these there are other vessels that drain directly into the heart chambers

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 22 - Which of the following causes the closure of the ductus arteriosus during birth?...

    Incorrect

    • Which of the following causes the closure of the ductus arteriosus during birth?

      Your Answer:

      Correct Answer: Reduced levels of prostaglandins

      Explanation:

      Ductus arteriosus is kept open by the prostaglandin E2 which is a vasodilator. At birth the high levels of cyclooxygenase blocks the production of prostaglandins which results in the closure of the ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 23 - With regard to the endothelial structure, the epithelium constitute: ...

    Incorrect

    • With regard to the endothelial structure, the epithelium constitute:

      Your Answer:

      Correct Answer: Simple squamous

      Explanation:

      The single layer of squamous epithelium lining the heart and blood vessels is known as the endothelium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 24 - Coronary blood flow occurs in? ...

    Incorrect

    • Coronary blood flow occurs in?

      Your Answer:

      Correct Answer: Diastole

      Explanation:

      Coronary arteries are unique in that they fill during diastole, when not occluded by valve cusps nor compressed by myocardial contraction).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 25 - The pressure in the sinusoids is normally: ...

    Incorrect

    • The pressure in the sinusoids is normally:

      Your Answer:

      Correct Answer: Lower than portal venous pressure

      Explanation:

      The direction of transport of nutrients in the portal vein occurs from the portal vein to the hepatic sinusoids. Thus, he pressure of sinusoids should be lower than the pressure of he portal vein.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds
  • Question 26 - Erythropoietin is synthesized by which cells of the nephron? ...

    Incorrect

    • Erythropoietin is synthesized by which cells of the nephron?

      Your Answer:

      Correct Answer: Tubular interstitial cells

      Explanation:

      Erythropoietin is produced by interstitial fibroblasts in the kidney in close association with peritubular capillary and proximal convoluted tubule. It is also produced in perisinusoidal cells in the liver. While liver production predominates in the fetal and perinatal period, renal production is predominant during adulthood.

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
      Seconds
  • Question 27 - Approximately what percentage of the world is infected with tuberculosis: ...

    Incorrect

    • Approximately what percentage of the world is infected with tuberculosis:

      Your Answer:

      Correct Answer: 25%

      Explanation:

      The WHO report states that about one-quarter of the world’s population is infected with Mycobacterium tuberculosis, the bacterium that causes tuberculosis. This means approximately 25% of people globally have latent TB infection, which can potentially progress to active TB disease.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds
  • Question 28 - Coronary arteries arise from? ...

    Incorrect

    • Coronary arteries arise from?

      Your Answer:

      Correct Answer: None of the above

      Explanation:

      Coronary arteries arise from the sinuses behind 2 of the cusps of the aortic valve at the root of aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 29 - Microtubule disassembly: ...

    Incorrect

    • Microtubule disassembly:

      Your Answer:

      Correct Answer: Occurs at the positive and negative end

      Explanation:

      Dynamic instability refers to the coexistence of assembly and disassembly at the ends of a microtubule. The microtubule can dynamically switch between growing and shrinking phases in this region. Although both assembly and disassembly occur at both ends they occur preferentially at the (+) end.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds
  • Question 30 - A 31 year old female complains of bilateral proximal muscle weakness. There is...

    Incorrect

    • A 31 year old female complains of bilateral proximal muscle weakness. There is marked blanching of fingers especially in response to cold weather. Lab results are as follows: Anti Jo-1: positive ANA: positiveCK: 2000 U/LESR: 60mm/hrEMG: myopathic changesPresence of which of the following signifies the worst prognosis?

      Your Answer:

      Correct Answer: Interstitial lung disease

      Explanation:

      Polymyositis is an inflammatory disorder causing symmetrical, proximal muscle weakness. It is thought to be a T-cell mediated cytotoxic process directed against muscle fibres. It may be idiopathic or associated with connective tissue disorders. It may also be associated with malignancy for example small cell lung carcinoma.Dermatomyositis is a variant of the disease where skin manifestations are prominent, for example a purple (heliotrope) rash on the cheeks and eyelids.It typically affects middle-aged, female: male 3:1. Features include proximal muscle weakness +/- tenderness, Raynaud’s phenomenon, respiratory muscle weakness, interstitial lung disease: e.g. fibrosing alveolitis or organising pneumonia, dysphagia, dysphonia. Investigations: elevated creatine kinase, other muscle enzymes (lactate dehydrogenase (LD), aldolase, AST and ALT) are also elevated in 85-95% of patients, EMG, muscle biopsy. Anti-Jo-1 antibodies are seen in pattern of disease associated with lung involvement, Raynaud’s and fever. Interstitial lung disease plays a major role in morbidity and mortality in patients with polymyositis and is considered a major risk factor for premature death in patients with myositis.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds
  • Question 31 - A 26 year old woman is 32 weeks pregnant. She has a history...

    Incorrect

    • A 26 year old woman is 32 weeks pregnant. She has a history of Sjogren Syndrome. The foetus would be at a risk for which of the following?

      Your Answer:

      Correct Answer: All correct

      Explanation:

      Women with Sjögren syndrome are likely to experience more complications during pregnancy than women without an autoimmune disease as the anti-Ro and anti-La antibodies cross the placenta and lead to various life threatening complications. Studies show a high incidence of poor fetal outcomes for these patients. Congenital heart block, neonatal lupus, congestive cardiac failure, hydrops fetalis can all be caused as a result of Sjogren syndrome.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds
  • Question 32 - Heart rate can be slowed by: ...

    Incorrect

    • Heart rate can be slowed by:

      Your Answer:

      Correct Answer: Grief

      Explanation:

      Grief stimulates the parasympathetic nervous system, resulting in a decrease in the heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 33 - Choose the correct answer: The cerebrocerebellum… ...

    Incorrect

    • Choose the correct answer: The cerebrocerebellum…

      Your Answer:

      Correct Answer: All options are correct

      Explanation:

      Cerebrocerebellum is comprised of two lateral regions, the cerebellar hemispheres and communicates with the cerebral cortex. It is principally responsible for controlling coordination of movement. Three fiber bundles carry the input and output of the cerebellum. There are three cerebellar peduncles with different connections and functions. The three are mainly, superior, middle and inferior. The superior cerebellar peduncle is also known as the “Brachium conjunctivum”. It predominantly contains efferent fibers from the cerebellar nuclei, as well as some afferents from the spinocerebellar tract. The efferent pathways include cerebellorubral, dentatothalamic, and fastigioreticular fibers. These are tracts projecting from the deep cerebellar nuclei to the thalamus and red nucleus. The middle cerebellar peduncle connects to the pontine nucleus and the dorsal spinocerebellar tracts run through the superior cerebellar peduncle

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds
  • Question 34 - The complex twisting and folding of peptide chains describes which order of protein...

    Incorrect

    • The complex twisting and folding of peptide chains describes which order of protein structure?

      Your Answer:

      Correct Answer: Secondary structure

      Explanation:

      Secondary Structure refers to the coiling or folding of a polypeptide chain that gives the protein its 3-D shape. There are two types of secondary structures: the alpha (α) helix and the beta (β) pleated sheet.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds
  • Question 35 - In liver failure there is likely to be? ...

    Incorrect

    • In liver failure there is likely to be?

      Your Answer:

      Correct Answer: Bleeding disorders

      Explanation:

      Liver failure can lead to several significant changes in the body’s physiology, but let’s review each option in the context of liver failure:

      1. Raised blood urea: This is not typical of liver failure. In liver failure, blood urea nitrogen (BUN) levels are often low because the liver is not effectively converting ammonia to urea.
      2. Increase in the albumin/globulin ratio in the blood: This is incorrect. In liver failure, albumin production decreases, leading to a lower albumin/globulin ratio.
      3. Bleeding disorders: This is possible, but it often fluctuates. Liver failure can lead to both bleeding tendencies due to decreased production of clotting factors and a hypercoagulable state due to the reduced synthesis of anticoagulant proteins like Protein C and S.
      4. Stable blood glucose level: This is incorrect. Liver failure often causes hypoglycemia because the liver’s ability to produce glucose via gluconeogenesis and glycogenolysis is impaired.
      5. Increased absorption of fat: This is incorrect. Liver failure can lead to decreased bile production, which is necessary for fat emulsification and absorption, resulting in decreased fat absorption.

      Given these points, the most likely option related to liver failure would actually be issues related to bleeding complications.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds
  • Question 36 - What is the function of secondary messengers? ...

    Incorrect

    • What is the function of secondary messengers?

      Your Answer:

      Correct Answer: Communication from extracellular to intracellular signalling pathways

      Explanation:

      First messengers may not physically cross the phospholipid bilayer to initiate changes within the cell directly. This functional limitation necessitates the cell to devise signal transduction mechanisms to transduce first messenger into second messengers, so that the extracellular signal may be propagated intracellularly. Second messengers are intracellular signalling molecules released by the cell to trigger physiological changes such as proliferation, differentiation, migration, survival, and apoptosis. Secondary messengers are therefore one of the initiating components of intracellular signal transduction cascades.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds
  • Question 37 - A 25-year-old male presented to accident and emergency 4 days ago, following an...

    Incorrect

    • A 25-year-old male presented to accident and emergency 4 days ago, following an intentional paracetamol overdose. He had taken 20x 500mg tablets, all at once. He denies any alcohol intake. Blood investigations 4 hours after ingestion showed:Paracetamol: 14 mg/lINR: 1Liver enzymes: No abnormality detectedBilirubin: Mild elevationHe was seen by the mental health team and discharged. The blood investigations were repeated:Bilirubin: Within normal limitsUrea: 21 mmol/lCreatinine: 300 µmol/lWhat is the likely cause of these results?

      Your Answer:

      Correct Answer: Delayed paracetamol nephrotoxicity

      Explanation:

      The most likely cause for these results is delayed paracetamol nephrotoxicity.The blood investigations of this patient are highly suggestive of acute kidney injury. Paracetamol overdose is well known to cause hepatotoxicity, but not for its delayed nephrotoxicity, especially in significant overdose. Appropriate monitoring of a patient’s blood tests is important.Management:NAC (N-Acetyl cysteine) has a clear role in preventing acetaminophen-induced liver necrosis. Although NAC has not been proven to be harmful to the kidney, its role in patients without hepatoxicity and only isolated renal dysfunction is uncertain.Other options:-There are no features in the history that are suggestive of dehydration and pre-renal AKI presenting in this manner in a 25-year-old would be very unusual.- Minimal change nephropathy typically presents with a nephrotic picture of kidney injury.- Berger’s more commonly presents with isolated haematuria.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds
  • Question 38 - The chemosensitive area in the medulla responds to: ...

    Incorrect

    • The chemosensitive area in the medulla responds to:

      Your Answer:

      Correct Answer: High hydrogen and high carbon dioxide

      Explanation:

      The chemosensitive area in the medulla responds mainly to high pH levels and carbon dioxide levels. Baroreceptors in the carotid and aortic body respond mainly to oxygen and carbon dioxide partial pressure in blood.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      0
      Seconds
  • Question 39 - The TSH receptor produces its effects in the thyrocyte via: ...

    Incorrect

    • The TSH receptor produces its effects in the thyrocyte via:

      Your Answer:

      Correct Answer: G-protein coupled activation of adenylyl cyclise and phospholipase c

      Explanation:

      The thyrotropin receptor, also known as TSH receptor, responds to the thyroid stimulating hormone or thyrotropin to stimulate production of T3 and T4. It is a G protein-coupled receptor which leads to stimulation of phospholipase C and adenylyl cyclase, mediated by Gq/11 and Gs.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds
  • Question 40 - An 80 year old female, previously diagnosed with polymyalgia rheumatica 18 months back,...

    Incorrect

    • An 80 year old female, previously diagnosed with polymyalgia rheumatica 18 months back, presents to the outpatient clinic with bilateral shoulder stiffness and generalized myalgia. The ESR was found to be 60mm/1st hour at the time of presentation. Prednisolone therapy was initiated at a daily dose of 15 mg along with Calcium and Vitamin supplementation. She reported resolution of her symptoms in one week. However the symptoms relapsed when the prednisolone dose was reduced below the current dose of 12.5 mg daily. How should she be ideally managed?

      Your Answer:

      Correct Answer: Continue the current dose of prednisolone and start methotrexate

      Explanation:

      Polymyalgia rheumatica, a syndrome characterized by proximal muscle pain and stiffness in older persons, generally is treated with prednisone. Dosages of 15 to 25 mg of prednisone per day can reduce inflammation considerably, although many patients relapse when therapy is tapered. Long-term (18 to 36 months) steroid treatment has been recommended by several studies, but this can result in multiple side effects, including osteoporosis, hypertension, cataracts, and hyperglycaemia. Methotrexate has been used to reduce inflammation in rheumatoid arthritis, systemic vasculitis, and giant cell arteritis, and in some studies has been combined with prednisone to treat polymyalgia rheumatica, decreasing the duration of treatment.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds
  • Question 41 - Transport of Iron into enterocytes occurs via which membrane transporter? ...

    Incorrect

    • Transport of Iron into enterocytes occurs via which membrane transporter?

      Your Answer:

      Correct Answer: Divalent metal transporter 1(dmt1)

      Explanation:

      To be absorbed, dietary iron can be absorbed as part of a protein such as haem protein or iron must be in its ferrous Fe2+ form. A ferric reductase enzyme on the enterocytes’ brush border, duodenal cytochrome B (Dcytb), reduces ferric Fe3+ to Fe2+. A protein called divalent metal transporter 1 (DMT1), which can transport several divalent metals across the plasma membrane, then transports iron across the enterocyte’s cell membrane into the cell.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds
  • Question 42 - Bone marrow barrier is important to: ...

    Incorrect

    • Bone marrow barrier is important to:

      Your Answer:

      Correct Answer: Allow mature red blood cells to pass into circulation

      Explanation:

      The blood vessels of the bone marrow constitute a barrier, inhibiting immature blood cells from leaving the marrow. Only mature blood cells contain the membrane proteins, such as aquaporin and glycophorin, that are required to attach to and pass the blood vessel endothelium.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds
  • Question 43 - What are the major motor proteins that interact with microtubules? ...

    Incorrect

    • What are the major motor proteins that interact with microtubules?

      Your Answer:

      Correct Answer: Kinesin and dynein

      Explanation:

      The major motor proteins that interact with microtubules are kinesin, which usually moves toward the (+) end of the microtubule, and dynein, which moves toward the (−) end.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds
  • Question 44 - As assessed by immunocytochemistry and electron microscopy, the anterior pituitary gland contains how...

    Incorrect

    • As assessed by immunocytochemistry and electron microscopy, the anterior pituitary gland contains how many different types of cells?

      Your Answer:

      Correct Answer: 5

      Explanation:

      The pituitary is divided into three sections

      -the anterior lobe which constitute the majority of the pituitary mass and is composed primarily of five hormone-producing cell types (thyrotropes, lactotropes, corticotropes, somatotropes and gonadotropes) each secreting thyrotropin, prolactin, ACTH, growth hormone and gonadotropins (FSH and LH) respectively.

      There is also a sixth cell type in the anterior lobe -the non-endocrine, agranular, folliculostellate cells.

      The intermediate lobe produces melanocyte-stimulating hormone and endorphins, whereas the posterior lobe secretes anti-diuretic hormone (vasopressin) and oxytocin.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds
  • Question 45 - The majority of corticospinal tract fibers decussate in the: ...

    Incorrect

    • The majority of corticospinal tract fibers decussate in the:

      Your Answer:

      Correct Answer: Medulla

      Explanation:

      The corticospinal tract is a descending motor path way that begins in the cerebral cortex and decussates in the pyramids of the medulla.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds
  • Question 46 - How does pregnancy affect the cardiac output of a patient? ...

    Incorrect

    • How does pregnancy affect the cardiac output of a patient?

      Your Answer:

      Correct Answer: Increased cardiac output due to increase in heart rate and stroke volume

      Explanation:

      Cardiac Output increases to a similar degree as the blood volume. During the first trimester cardiac output is 30-40% higher than in the non-pregnant state. Steady rises are shown on Doppler echocardiography, from an average of 6.7 litres/minute at 8-11 weeks to about 8.7 litres/minute flow at 36-39 weeks; they are due, primarily, to an increase in stroke volume (35%) and, to a lesser extent, to a more rapid heart rate (15%). There is a steady reduction in systemic vascular resistance (SVR) which contributes towards the hyperdynamic circulation observed in pregnancy

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 47 - Which of the following with regard to DNA mutations does not fit: ...

    Incorrect

    • Which of the following with regard to DNA mutations does not fit:

      Your Answer:

      Correct Answer: All gene mutations cause clinical disease entities

      Explanation:

      All gene mutations do not cause a clinical manifestation of the disease, some gene mutations are silent mutations. They are present but do not cause any disease.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds
  • Question 48 - Which neurotransmitter is found in the postganglionic parasympathetic synaptic cleft? ...

    Incorrect

    • Which neurotransmitter is found in the postganglionic parasympathetic synaptic cleft?

      Your Answer:

      Correct Answer: Acetylcholine

      Explanation:

      Acetylcholine is the neurotransmitter released from the postganglionic parasympathetic neuron into the synaptic cleft and also by some postganglionic sympathetic neurons as well.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds
  • Question 49 - The average end diastolic volume in a healthy individual’s ventricle is? ...

    Incorrect

    • The average end diastolic volume in a healthy individual’s ventricle is?

      Your Answer:

      Correct Answer: 130 ml

      Explanation:

      The end diastolic volume in a healthy individual is about 130 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds
  • Question 50 - Which of the following is a product of D cells ...

    Incorrect

    • Which of the following is a product of D cells

      Your Answer:

      Correct Answer: Somatostatin

      Explanation:

      Somatostatin is secreted by D cells, HCL and intrinsic factor secreted by parietal cells. Trefoil peptides are secreted by mucus secreting goblet cells and gastrin releasing peptide (grp) by post-ganglionic fibers of the vagus nerve (which innervate the G cells of the stomach).

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cell Biology (1/1) 100%
Medicine (2/3) 67%
Metabolism (1/1) 100%
Gastrointestinal (0/1) 0%
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