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  • Question 1 - Which of the following is true for P53: ...

    Correct

    • Which of the following is true for P53:

      Your Answer: It is induced by ‘broken’ DNA

      Explanation:

      P53 gene is activated as a result of damaged DNA and if that cannot be repaired then it activates apoptosis.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      832.1
      Seconds

  • Question 2 - A 20 year old male student presents to the clinic with swelling of...

    Correct

    • A 20 year old male student presents to the clinic with swelling of his face, hands and feet along with diffuse abdominal pain. He has a history of similar recurrent episodes since he was 10 years old, with each episode lasting 2-3 days. Examination reveals swelling on face, hands, feet but no sign of urticaria. Family history is significant for similar episodes in the mother who experienced these since childhood, and a brother who passed away following respiratory distress at age of 8 during one such episode. Which of the following tests would be the most helpful in reaching the diagnosis?

      Your Answer: C1 esterase inhibitor

      Explanation:

      Hereditary C1 inhibitor deficiency leads to recurrent angioedema without urticaria or pruritus. Physical triggers include dental work, surgery or intubation. Medical triggers include angiotensin-converting enzyme (ACE) inhibitor, tamoxifen, oestrogen-containing medications (e.g., hormone replacement therapy and oral contraceptives). It is diagnosed on the basis of low levels of C1 esterase inhibitor or elevated levels of dysfunctional C1 esterase inhibitor. C4 levels are low between attacks. IgE levels, eosinophils, skin prick tests and RASTs are helpful in other allergic conditions and asthma but not of use in this case.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      12.6
      Seconds

  • Question 3 - Myocardial contractility is improved by: ...

    Correct

    • Myocardial contractility is improved by:

      Your Answer: Caffeine

      Explanation:

      Caffeine and other theophyllines breakdown cAMP and have a positive ionotropic effect on the heart. Drugs like quinidine, procainamide and conditions like hypoxia and hypercapnia decreases the contractility of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      184.9
      Seconds

  • Question 4 - A 43 year old man with hemochromatosis presents with a painful and swollen...

    Correct

    • A 43 year old man with hemochromatosis presents with a painful and swollen right knee. X-ray shows extensive chondrocalcinosis but no fracture. Given the most likely diagnosis, which of the following would be present in the joint fluid aspirate?

      Your Answer: Positively birefringent rhomboid-shaped crystals

      Explanation:

      Pseudogout is a paroxysmal joint inflammation due to calcium pyrophosphate crystal deposition (calcium pyrophosphate dihydrate). Arthrocentesis should be performed, especially in acute cases. Polarized light microscopy: detection of rhomboid-shaped, positively birefringent CPPD crystals. Synovial fluid findings: 10,000-50,000 WBCs/μL with > 90% neutrophils. X-ray findings: cartilage calcification of the affected joint (chondrocalcinosis). Fibrocartilage (meniscus, annulus fibrosus of intervertebral disc) and hyaline cartilage (joint cartilage) may be affected.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      14.2
      Seconds

  • Question 5 - Which dorsal (sensory) root is responsible for umbilical area sensation? ...

    Correct

    • Which dorsal (sensory) root is responsible for umbilical area sensation?

      Your Answer: T10

      Explanation:

      The area of skin supplied by one nerve is called a dermatome. T10 supplies sensory neurons to the area of the umbilicus. C3 and C4 supply the neck and the shoulder, T4 supplies the dermatome at the level of the nipple, S3 supplies the inguinal region and L5 supplies the lateral aspect of the leg and the medical aspect of the dorsum of the feet plus the first 3 toes.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      4.1
      Seconds

  • Question 6 - Under normal conditions (where n represents the number of chromosome pairs), just before...

    Correct

    • Under normal conditions (where n represents the number of chromosome pairs), just before mitosis begins, how many chromosomes are contained in the nucleus of each somatic cell:

      Your Answer: 4n

      Explanation:

      In a normal somatic cell there are 2n chromosome but in a replicating cell just before mitosis the chromosomes duplicate but are still joined via the centrosome. Thus there are 4n chromosomes. After completion of mitosis the number goes back to 2n.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      13.6
      Seconds

  • Question 7 - The net effect of active Vitamin D on calcium and phosphate homeostasis is?...

    Correct

    • The net effect of active Vitamin D on calcium and phosphate homeostasis is?

      Your Answer: Increase in Ca, increase in phosphate

      Explanation:

      Bone and its metabolism are regulated by several hormones, amongst which is vitamin D. It is heavily involved in the metabolism and homeostasis of calcium and phosphate through several processes. Vitamin D works in the intestine, kidney, bone and parathyroid glands to maintain levels of calcium and phosphate, promoting its absorption, bone resorption, and proper functioning of the parathyroid to maintain adequate serum calcium levels.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      15.9
      Seconds

  • Question 8 - Which of the following is the smallest cell of the nervous system? ...

    Correct

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

      Your 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
      2.9
      Seconds

  • Question 9 - With regard to the spleen which of the following has the correct match?...

    Incorrect

    • With regard to the spleen which of the following has the correct match?

      Your Answer: Marginal zone - B lymphocytes

      Correct Answer: Periarteriolar lymphoid sheets - T lymphocytes

      Explanation:

      The spleen consists of:Red pulp – responsible for mechanical filtration of red blood cells. Red pulp contains sinusoids, which are filled with blood, splenic cords of reticular fibers and a marginal zoneWhite pulp – responsible for active immune response through humoral and cell-mediated pathways. Composed of nodules, called Malpighian corpuscles. These are composed of: lymphoid follicles, rich in B-lymphocytes and periarteriolar lymphoid sheaths, rich in T-lymphocytes

    • This question is part of the following fields:

      • Haematology
      • Medicine
      108.9
      Seconds

  • Question 10 - Which one of the following nerve fibers has the fastest conduction velocity? ...

    Correct

    • Which one of the following nerve fibers has the fastest conduction velocity?

      Your Answer: α fiber

      Explanation:

      α nerve fibers are characterized by being highly myelinated, which confers them with fast conduction properties. They innervate extrafusal skeletal muscle fibers, and their conduction velocity is between 80-120 m/s.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      6.1
      Seconds

  • Question 11 - The majority striatal neurons, called medium spiny neurons, utilizes which neurotransmitter? ...

    Correct

    • The majority striatal neurons, called medium spiny neurons, utilizes which neurotransmitter?

      Your Answer: GABA

      Explanation:

      Medium spiny neurons are inhibitory neurons which use GABA (gamma-aminobutyric acid) which exerts inhibitory actions. These cells represent 95% of neurones within the human striatum found in basal ganglia.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      10.4
      Seconds

  • Question 12 - Telomerase is active in the following cells except: ...

    Correct

    • Telomerase is active in the following cells except:

      Your Answer: Certain osteoblasts

      Explanation:

      Some cells have the ability to reverse telomere shortening by expressing telomerase, an enzyme that extends the telomeres of chromosomes. Telomerase is an RNA-dependent DNA polymerase, meaning an enzyme that can make DNA using RNA as a template.

      Telomerase is not usually active in most somatic cells (cells of the body), but it’s active in germ cells (the cells that make sperm and eggs) and some adult stem cells. These are cell types that need to undergo many divisions, or, in the case of germ cells, give rise to a new organism with its telomeric “clock” reset.
      Interestingly, many cancer cells have shortened telomeres, and telomerase is active in these cells. If telomerase could be inhibited by drugs as part of cancer therapy, their excess division (and thus, the growth of the cancerous tumor) could potentially be stopped.
       A subset of liver cells with high levels of telomerase renews the organ during normal cell turnover and after injury.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      4.3
      Seconds

  • Question 13 - Lymphoid stem cells give rise to the following cells: ...

    Incorrect

    • Lymphoid stem cells give rise to the following cells:

      Your Answer: T and b cells only

      Correct Answer: T cells, b cells and natural killer cells

      Explanation:

      T Cells, B Cells and NK Cells (and all other Innate lymphoid cells) are unique to the lymphocyte family, but dendritic cells are not. Dendritic cells of identical appearance but different markers are spread throughout the body, and come from either lymphoid and myeloid lineages.

      Myeloid stem cells lead to myeloblasts, which evolve into macrophages, monocytes, neutrophils, basophils, and eosinophils.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      14.1
      Seconds

  • Question 14 - The first enzyme carbohydrates encounter in the digestive tract is? ...

    Correct

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

      Your 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
      4.8
      Seconds

  • Question 15 - Which statement is correct about the clinical state of methemoglobinemia? ...

    Correct

    • Which statement is correct about the clinical state of methemoglobinemia?

      Your Answer: May arise due to a hereditary deficiency of NADH.

      Explanation:

      Methaemoglobin is a form of haemoglobin that contains ferric [Fe3+] iron and has a decreased ability to bind oxygen. Spontaneously formed methaemoglobin is normally reduced by protective enzyme systems, e.g., NADH methaemoglobin reductase, hence a deficiency of NADH may result in increased levels of methaemoglobin

    • This question is part of the following fields:

      • Haematology
      • Medicine
      12.1
      Seconds

  • Question 16 - The interventricular septum is supplied anteriorly by the? ...

    Incorrect

    • The interventricular septum is supplied anteriorly by the?

      Your Answer:

      Correct Answer: Left anterior descending artery

      Explanation:

      The anterior interventricular artery or left anterior descending artery supplies the anterior 2/3rds of the interventricular septum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 17 - A 30-year-old woman is admitted for drainage of an abscess in her left...

    Incorrect

    • A 30-year-old woman is admitted for drainage of an abscess in her left forearm. She has revealed that she was regular heroin user and has stopped for the past few days. Clinical signs are pointing towards opioid withdrawal. What is the next step in managing this patient?

      Your Answer:

      Correct Answer: Give her 10 mg of methadone syrup and wait 60 min to determine its effect

      Explanation:

      The next step in managing this patient is to give 10 mg and continue administering in 10 mg increments each hour until symptoms are under control.Methadone alleviates opioid withdrawal symptoms and reduces cravings. Methadone is useful for detoxification from longer-acting opioids such as morphine or methadone itself.Methadone should be used with caution if the patient has:Respiratory deficiencyAcute alcohol dependenceHead injuryTreatment with monoamine oxidase inhibitors (MAOIs)Ulcerating colitis or Crohn’s diseaseSevere hepatic impairmentThe dose must be reviewed on a daily basis and adjusted based upon how well the symptoms are controlled and the presence of side effects. The greater the dose of opioids used by the patient, the greater the dose of methadone required to control withdrawal symptoms. To avoid the risk of overdose in the first days of treatment The recommended dosing of methadone is 30mg in two doses of 15mg morning and evening.It is important to note that a methadone dose equivalent to what the patient reports they are taking should never be given. It is rare to need more than 40 mg per 24 hours: beware of overdosing which can lead to respiratory arrest.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 18 - What microscopic changes are visible in an active thyroid gland? ...

    Incorrect

    • What microscopic changes are visible in an active thyroid gland?

      Your Answer:

      Correct Answer: Follicle lining cells are cuboid or columnar.

      Explanation:

      Active follicles are lined by cuboidal or columnar cells; this is because active follicles are smaller and have less colloid. Their cells are tall because they are actively secreting hormones, whereas older follicles have a flat epithelium and are filled with more colloid.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 19 - The heart rate can be accelerated by: ...

    Incorrect

    • The heart rate can be accelerated by:

      Your Answer:

      Correct Answer: Exercise and thyroid hormones

      Explanation:

      The firing of the SA node will increase due to exercises and as the thyroid hormone has a chronotropic effect on the heart, it too will result in an increase in the heart rate via stimulation of the adrenergic receptors of the heart. As during exercise the sympathetic nervous system is activated, it will directly have an positive chronotropic effect on the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 20 - 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 21 - Which of the following stimuli increase growth hormone secretion? ...

    Incorrect

    • Which of the following stimuli increase growth hormone secretion?

      Your Answer:

      Correct Answer: Ghrelin

      Explanation:

      Ghrelin is a hormone which serves as an endogenous ligand for the growth hormone secretagogue receptor. It acts on the pituitary and the hypothalamus by affecting the vagus nerve. It acts on the somatotrophs of the anterior pituitary, GHRH-secreting neurons, and on GHIH-secreting neurons in the hypothalamus, causing a time-dependent and pulsatile stimulation over the secretion of growth hormone.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 22 - Neutrophils are attracted to an infected area by: ...

    Incorrect

    • Neutrophils are attracted to an infected area by:

      Your Answer:

      Correct Answer: Chemokines

      Explanation:

      The major role of chemokines is to act as a chemoattractant to guide the migration of cells like neutrophils to the site of infection.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 23 - A 53 year old female, longstanding case of rheumatoid arthritis comes for a...

    Incorrect

    • A 53 year old female, longstanding case of rheumatoid arthritis comes for a review. Which of the following features are commonly associated with her condition?

      Your Answer:

      Correct Answer: Proximal interphalangeal joint involvement in the hands

      Explanation:

      Rheumatoid arthritis is a polyarthritis that results in symmetrical pain and swelling of the affected joints (also at rest). It particularly affects the metacarpophalangeal joints (MCPJs) and proximal interphalangeal joints (PIPJs), not the distal interphalangeal joints (DIPs). Ulcerative colitis and IBD are associated with seronegative arthritides, not RA. The condition can also cause various extra-articular manifestations such as ocular symptoms, rheumatoid nodules and pulmonary fibrosis. Scleritis, episcleritis and keratoconjunctivitis sicca are more common than uveitis. Early intervention with disease-modifying antirheumatic drugs (DMARDs) plays a decisive role in successful treatment.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 24 - A 42 year old male arrives at the clinic due to cough and...

    Incorrect

    • A 42 year old male arrives at the clinic due to cough and haemoptysis. Examination shows nasal mucosal ulceration. The doctor suspects Wegener's granulomatosis. Which anatomical area would be most commonly involved in this condition?

      Your Answer:

      Correct Answer: Lungs

      Explanation:

      Granulomatosis with polyangiitis (GPA, previously known as Wegener’s granulomatosis) is a systemic vasculitis that affects both small and medium-sized vessels. Patients typically initially suffer from a limited form that may consist of constitutional symptoms and localized manifestations such as chronic sinusitis, rhinitis, otitis media, ocular conditions. In later stages, more serious manifestations may arise, including pulmonary complications and glomerulonephritis, although the skin, eyes, and heart may also be involved but these lesions are less common. Diagnosis is based on laboratory testing (positive for PR3-ANCA/c-ANCA), imaging, and biopsy of affected organs, which demonstrate necrotizing granulomatous inflammation. GPA is treated with immunosuppressive drugs, typically consisting of glucocorticoids combined with methotrexate, cyclophosphamide, or rituximab. Relapses are common and the following systems are affected: Lower respiratory tract (95% of cases), renal involvement (80% of cases), skin lesions (45% of cases), ocular involvement (45% of cases) and cardiac involvement (33% of cases).

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 25 - Which one of these features is typical of dermatomyositis? ...

    Incorrect

    • Which one of these features is typical of dermatomyositis?

      Your Answer:

      Correct Answer: Gottron's papules over knuckles of fingers

      Explanation:

      The main symptom of dermatomyositis include skin rash and symmetric proximal muscle weakness (in over 90% of patients) which may be accompanied by pain and tenderness. It occurs more commonly in females. Skin findings include:Gottron’s sign – an erythematous, scaly eruption occurring in symmetric fashion over the MCP and interphalangeal jointsHeliotrope or lilac rash – a violaceous eruption on the upper eyelids and in rare cases on the lower eyelids as well, often with itching and swellingShawl (or V-) sign is a diffuse, flat, erythematous lesion over the back and shoulders or in a V over the posterior neck and back or neck and upper chest, which worsens with UV light. Erythroderma is a flat, erythematous lesion similar to the shawl sign but located in other areas, such as the malar region and the forehead. Periungual telangiectasias and erythema occur.

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      0
      Seconds

  • Question 26 - The infoldings or spaces between the bases of the villi are known as...

    Incorrect

    • The infoldings or spaces between the bases of the villi are known as

      Your Answer:

      Correct Answer: Crypts of Lieberkühn

      Explanation:

      An intestinal gland (also crypt of Lieberkühn and intestinal crypt) is a gland found in the intestinal epithelium lining of the small intestine and large intestine (colon) between the villi.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 27 - On a mountain the atmospheric pressure is 700 mmHg and the humidity close...

    Incorrect

    • On a mountain the atmospheric pressure is 700 mmHg and the humidity close to zero, the partial pressure of oxygen is:

      Your Answer:

      Correct Answer: 147 mmHg

      Explanation:

      Natural air includes approximately 21% of oxygen. If humidity is zero, the partial pressure of oxygen is 700 × 21% = 147 mmHg

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      0
      Seconds

  • Question 28 - What is the primary problem of achalasia ...

    Incorrect

    • What is the primary problem of achalasia

      Your Answer:

      Correct Answer: Deficiency of myenteric plexus at the lower oesophageal sphincter

      Explanation:

      Oesophageal achalasia is an oesophageal motility disorder involving the smooth muscle layer of the oesophagus is characterized by the failure of the lower oesophageal sphincter (LES) relaxation and aperistalsis, caused primarily by the loss of the inhibitory innervation of the oesophageal myenteric plexus.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 29 - Among the following which is the beneficial effect of nitro-glycerine? ...

    Incorrect

    • Among the following which is the beneficial effect of nitro-glycerine?

      Your Answer:

      Correct Answer: Dilation of systemic veins

      Explanation:

      Dilation of systemic veins is a beneficial effect of nitro-glycerine.Administration of nitro-glycerine results in the dilation of systemic veins and decrease of myocardial wall tension and oxygen demand. Dilatation of systemic veins can cause reduced systemic vascular resistance leading to reduced cardiac workload thus reducing anginal symptoms secondary to demand ischemia.This is accompanied by vasodilation of large and medium-sized coronary arteries with increased coronary blood flow to the sub endocardium.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 30 - Major supplies of glycogen are found in …. ...

    Incorrect

    • Major supplies of glycogen are found in ….

      Your Answer:

      Correct Answer: Liver and skeletal muscle

      Explanation:

      The two major sites of glycogen storage are the liver and skeletal muscle. The concentration of glycogen is higher in the liver than in muscle however more glycogen is stored in skeletal muscle due to its greater mass.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 31 - Which hormone results in the production of pancreatic juice rich in enzymes but...

    Incorrect

    • Which hormone results in the production of pancreatic juice rich in enzymes but low in volume?

      Your Answer:

      Correct Answer: Cholecystokinin

      Explanation:

      Cholecystokinin (CCK) mediates digestion in the small intestine by inhibiting gastric emptying and decreasing gastric acid secretion. It stimulates the acinar cells of the pancreas to release a juice rich in pancreatic digestive enzymes, hence the old name pancreozymin.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 32 - The Plateau phase in myocyte action potentials does all of the following except:...

    Incorrect

    • The Plateau phase in myocyte action potentials does all of the following except:

      Your Answer:

      Correct Answer: It allows early reactivation of the myocytes

      Explanation:

      The presence of the plateau in the action potential causes ventricular contraction to last as much as 15 times longer in cardiac muscle as in skeletal muscle. The plateau phase which follows is unique to myocytes and results from a small, but sustained inward calcium current through L-type calcium channels lasting 200-400 ms. This calcium influx is caused by a combined increase in permeability of the cell and especially the sarcolemmal membranes to calcium. This plateau (refractory) phase prevents early reactivation of the myocytes and directly determines the strength of contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 33 - The ability of the SA node cells to allow ionic flow through channels...

    Incorrect

    • The ability of the SA node cells to allow ionic flow through channels activated in a hyperpolarized state is known as:

      Your Answer:

      Correct Answer: Pace maker potential

      Explanation:

      Rhythmically discharging cells have a membrane potential that, after each impulse, declines to the firing level. Thus this prepotential or Pacemaker potential triggers the next impulse. The inherent leakiness of the sinus nodal fibers to Na+ and Ca2+ causes their self excitation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 34 - A case-control study is developed to assess passive smoking as a risk factor...

    Incorrect

    • A case-control study is developed to assess passive smoking as a risk factor for the development of asthma in children. The total number of patients recruited for this study is 200. 40 out of the 200 patients report at least one parent smoking in the house when they were younger. 200 more people without asthma are recruited and 20 out of them report that at least one parent smoked in the house when they were younger. What is the odds ratio of patients with asthma having been exposed to passive smoking during their childhood?

      Your Answer:

      Correct Answer: 2.25

      Explanation:

      An odds ratio (OR) is a measure of association between an exposure and an outcome. The OR represents the odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure. Odds ratios are most commonly used in case-control studies, however they can also be used in cross-sectional and cohort study designs as well (with some modifications and/or assumptions). Wherea = Number of exposed casesb = Number of exposed non-casesc = Number of unexposed casesd = Number of unexposed non-casesOR=(a/c) / (b/d) = ad/bc

    • This question is part of the following fields:

      • Medicine
      • Research Skills
      0
      Seconds

  • Question 35 - Regarding Southern Blotting and DNA probes, which answer is FALSE ...

    Incorrect

    • Regarding Southern Blotting and DNA probes, which answer is FALSE

      Your Answer:

      Correct Answer: RNA fragments are separated by gel electrophoresis and transferred onto membrane sheets in southern blotting

      Explanation:

      Restriction enzymes always cut at different positions. There are different restriction endonucleases for different nucleotide sequences.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 36 - A 36 year old man arrives at the clinic complaining of pain and...

    Incorrect

    • A 36 year old man arrives at the clinic complaining of pain and swelling of the left knee, ankles and right hallux. He has acute conjunctivitis, and dysuria. He suffered from an episode of gastroenteritis two weeks back. Clinical examination shows left Achilles tendonitis and right plantar fasciitis. Radiological examination reveals left sacroiliitis, with evidence of enthesitis, joint erosions and periostitis. HLA-B27 is positive. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Reiter’s syndrome

      Explanation:

      Reactive arthritis, (formerly known as Reiter’s syndrome), is an autoimmune condition that occurs after a bacterial infection of the gastrointestinal or urinary tract. It is categorized as a seronegative spondylarthritis because of its association with HLA-B27. Reactive arthritis primarily affects young men and usually presents with musculoskeletal or extra‑articular symptoms. The characteristic triad consists of arthritis, conjunctivitis, and urethritis. The diagnosis is based on clinical features such as patient history and physical examination; there are no specific tests for reactive arthritis. Treatment is primarily symptomatic and consists of the administration of NSAIDs, as most patients recover spontaneously. extraarticular dermatologic manifestations include skin lesions of the glans resembling psoriasis (balanitis circinata); hyperkeratinisation of the palms and soles (keratoderma blenorrhagicum), oral ulcers.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 37 - VIP, GIP and somatostatin play an inhibitory role in gastric acid secretion by...

    Incorrect

    • VIP, GIP and somatostatin play an inhibitory role in gastric acid secretion by inactivating?

      Your Answer:

      Correct Answer: G cells

      Explanation:

      Gastrin is secreted from the G cells. VIP, GIP and somatostatin all inhibit acid production by inhibiting the G cells.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 38 - What percentage of blood is supplied to the liver by the portal vein?...

    Incorrect

    • What percentage of blood is supplied to the liver by the portal vein?

      Your Answer:

      Correct Answer: 75%

      Explanation:

      The portal vein supplies 75% of the blood to the liver and exceeds the arterial supply of the organ.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 39 - The triangle with the heart at its centre, using limb leads is called:...

    Incorrect

    • The triangle with the heart at its centre, using limb leads is called:

      Your Answer:

      Correct Answer: Einthoven

      Explanation:

      The Einthoven triangle is formed by placing the limb leads on both the arms and on the left leg with the heart in the centre.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 40 - A 33 year old female presents with dyspnoea, myalgia, arthralgia and a skin...

    Incorrect

    • A 33 year old female presents with dyspnoea, myalgia, arthralgia and a skin rash. The presence of which of the following antibodies would be the most specific for SLE?

      Your Answer:

      Correct Answer: Anti-Sm

      Explanation:

      Anti-Sm antibodies are essential for diagnosis of SLE, especially in anti-dsDNA-negative patients. ANA are also found in 95% of the patients with SLE but they may also occur with other conditions like Juvenile inflammatory arthritis, chronic activity hepatitis, and Sjogren’s syndrome. Anti-Ro, although also found with SLE are more characteristic of Sjogren Syndrome. RF is usually associated with rheumatoid arthritis and cANCA with Wegener’s granulomatosis, Churg Strauss, and microscopic polyangiitis.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 41 - The isoforms of nitric oxide synthase which are found in the nervous system...

    Incorrect

    • The isoforms of nitric oxide synthase which are found in the nervous system (NOS1) and endothelial cells (NOS3) are activated by agents that increase which of the following intracellular electrolytes?

      Your Answer:

      Correct Answer: Ca

      Explanation:

      Synthesis of nitric oxide is stimulated by activation of the NMDA receptors by certain agents. This leads to opening of the Calcium channels and an influx of calcium into the cell. This will activate the nitric oxide synthase. Nitric oxide is produced on demand.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 42 - The superior orbital fissure is the site of entry/exit for which of the...

    Incorrect

    • The superior orbital fissure is the site of entry/exit for which of the following group of nerves?

      Your Answer:

      Correct Answer: CN III, IV, V1, VI

      Explanation:

      The superior and inferior divisions of oculomotor nerve (III), trochlear nerve (IV), lacrimal, frontal and nasociliary branches of ophthalmic V1 and the abducens nerve (VI)

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 43 - Which enzyme deficiency causes pellagra? ...

    Incorrect

    • Which enzyme deficiency causes pellagra?

      Your Answer:

      Correct Answer: Niacin

      Explanation:

      Pellagra is a vitamin deficiency disease most frequently caused by a chronic lack of niacin (vitamin B3) in the diet.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 44 - In the malaria life cycle , parasites which remain dormant in the liver...

    Incorrect

    • In the malaria life cycle , parasites which remain dormant in the liver are known as :

      Your Answer:

      Correct Answer: Hypnozoites

      Explanation:

      The life-cycles of Plasmodium species involve several different stages both in the insect and the vertebrate host. These stages include sporozoites, which are injected by the insect vector into the vertebrate host’s blood. Sporozoites infect the host liver, giving rise to merozoites and (in some species) hypnozoites. These move into the blood where they infect red blood cells. In the red blood cells, the parasites can either form more merozoites to infect more red blood cells, or produce gametocytes which are taken up by insects which feed on the vertebrate host. In the insect host, gametocytes merge to sexually reproduce. After sexual reproduction, parasites grow into new sporozoites, which move to the insect’s salivary glands, from which they can infect a vertebrate host bitten by the insect

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 45 - With regard to cell membrane proteins: ...

    Incorrect

    • With regard to cell membrane proteins:

      Your Answer:

      Correct Answer: Carriers are involved in facilitated diffusion

      Explanation:

      Pumps use a source of free energy such as ATP to transport ions against a gradient and is an example of active transport. Unlike channel proteins which only transport substances through membranes passively, carrier proteins can transport ions and molecules either passively through facilitated diffusion, or via secondary active transport. Channels are either in open state or closed state. When a channel is opened, it is open to both extracellular and intracellular. Pores are continuously open to both environments, because they do not undergo conformational changes. They are always open and active.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 46 - Peristalsis is an example of: ...

    Incorrect

    • Peristalsis is an example of:

      Your Answer:

      Correct Answer: Enteric nervous system

      Explanation:

      Peristalsis is a type of contraction where radial symmetrical contraction and relaxation of muscles propagates food in a downward wave through the gut. The enteric nervous system is one of the main divisions of the nervous system and consists of a mesh-like system of neurons that controls the function of the gastrointestinal tract. It has an independent reflex activity. The neurons of this system re collected into two types of ganglia: myenteric (or Auerbach’s) and submucosal (or Meissner’s plexuses). Myenteric plexuses are located between the inner and outer layers of the muscularis externa, while submucosal plexuses are located in the submucosa.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 47 - AV valves open during? ...

    Incorrect

    • AV valves open during?

      Your Answer:

      Correct Answer: Early diastole

      Explanation:

      The cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause.The first stage, diastole, is when the semilunar valves (the pulmonary valve and the aortic valve) close, the atrioventricular (AV) valves (the mitral valve and the tricuspid valve) open, and the whole heart is relaxed. The second stage, atrial systole, is when the atrium contracts, and blood flows from atrium to the ventricle.The third stage, isovolumic contraction is when the ventricles begin to contract, the AV and semilunar valves close, and there is no change in volume. The fourth stage, ventricular ejection, is when the ventricles are contracting and emptying, and the semilunar valves are open. During the fifth stage, isovolumic relaxation time, pressure decreases, no blood enters the ventricles, the ventricles stop contracting and begin to relax, and the semilunar valves close due to the pressure of blood in the aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 48 - The following cells replicate without shortening their telomeres because they express telomerase. ...

    Incorrect

    • The following cells replicate without shortening their telomeres because they express telomerase.

      Your Answer:

      Correct Answer: Germ cells

      Explanation:

      Telomerase activity is seen in germ cells and is absent in somatic cells. Telomeres prevent the chromosomes from shortening and prevent the coding portion of the DNA from being lost, thus allowing the cell to replicate indefinitely. During replication telomeres may be lost resulting in cell death.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 49 - Which of the following enzymes is mainly responsible for the hydrolysis of polysaccharide...

    Incorrect

    • Which of the following enzymes is mainly responsible for the hydrolysis of polysaccharide 1:6a linkages?

      Your Answer:

      Correct Answer: Isomaltase

      Explanation:

      Isomaltase is mainly responsible for hydrolysis of 1:6α linkages. Along with maltase and sucrase, it also breaks down maltotriose and maltose.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 50 - A 35 year old female, known case of anti phospholipid syndrome, arrives at...

    Incorrect

    • A 35 year old female, known case of anti phospholipid syndrome, arrives at the clinic due to a swollen and painful left leg. Doppler ultrasonography confirms the diagnosis of a deep vein thrombosis. She was previously diagnosed with DVT 4 months back and was on warfarin therapy (target INR 2-3) when it occurred. How should her anticoagulation be managed?

      Your Answer:

      Correct Answer: Life-long warfarin, increase target INR to 3 - 4

      Explanation:

      If the INR in the range of 2-3 has still resulted in thrombosis, the target INR is increased to 3-4. However, because the risk of bleeding increases as the INR rises, the INR is closely monitored and adjustments are made as needed to maintain the INR within the target range.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 51 - The axons of the POST ganglionic neurons are mostly? ...

    Incorrect

    • The axons of the POST ganglionic neurons are mostly?

      Your Answer:

      Correct Answer: C fibers

      Explanation:

      According to Erlanger- Grasser classification preganglionic fibers are B fibers whereas post ganglionic fibers are C fibers.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 52 - A 35 year old sales representative presents with severe pain going down her...

    Incorrect

    • A 35 year old sales representative presents with severe pain going down her neck and right arm. She admits that this pain is worse on sitting and driving for long periods. Past history is significant for two previous road traffic accidents. Examination reveals weakness and sensory loss over C5/C6 nerve distribution. There is pain with neck movement and particularly extension. Which of the following investigations would be the most helpful in this case?

      Your Answer:

      Correct Answer: MRI scan of the cervical spinal cord

      Explanation:

      Cervical radiculopathy is usually due to compression or injury to a nerve root by a herniated disc or degenerative changes. Levels C5 to T1 are the most commonly affected. It is usually, but not always, accompanied by cervical radicular pain, a sharp and shooting pain that travels from the neck and down the upper limb and may be severe. This needs to be differentiated from pain referred from the musculoskeletal (somatic) structures in the neck, which may be aching rather than sharp, and is more severe in the neck than in the upper limb. The neurological signs of cervical radiculopathy depend on the site of the lesion. The patient may have motor dysfunction, sensory deficits or alteration in tendon reflexes. While pain is a common presenting symptom, not all radiculopathies are painful (i.e. only motor deficits may be obvious). CT scanning cannot accurately demonstrate the commonest cause for cervical radiculopathy (disc herniation) without myelography, which requires hospital admission, lumbar puncture and the use of contrast. In patients with cervical radiculopathy, MRI is the imaging technique of choice for the detection of root compression by disc herniation and osteophytes. MRI allows the nerve roots to be directly visualised. Nerve conduction studies are also useful in determining the nerve roots that are involved.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 53 - 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 54 - Which of the following vitamin deficiencies is associated with xerophthalmia? ...

    Incorrect

    • Which of the following vitamin deficiencies is associated with xerophthalmia?

      Your Answer:

      Correct Answer: Vitamin A

      Explanation:

      Xerophthalmia caused by a severe vitamin A deficiency is described by pathologic dryness of the conjunctiva and cornea. The conjunctiva becomes dry, thick and wrinkled. If untreated, it can lead to corneal ulceration and ultimately to blindness as a result of corneal damage.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 55 - With regards to splenic micro-architecture which is not contained within the red pulp...

    Incorrect

    • With regards to splenic micro-architecture which is not contained within the red pulp

      Your Answer:

      Correct Answer: Malpighian corpuscles

      Explanation:

      Red pulp is responsible for mechanical filtration of red blood cells and is composed of sinusoids, which are filled with blood, splenic cords of reticular fibers and a marginal zone bordering on white pulp. White pulp provides an active immune response through humoral and cell-mediated pathways. Composed of nodules, called Malpighian corpuscles. These are composed of: lymphoid follicles, rich in B-lymphocytes and periarteriolar lymphoid sheaths (PALS), rich in T-lymphocytes.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 56 - Which of the following is an incorrect statement regarding the structure of DNA?...

    Incorrect

    • Which of the following is an incorrect statement regarding the structure of DNA?

      Your Answer:

      Correct Answer: The two strands of DNA are held together by cysteine bonds.

      Explanation:

      The two strands of DNA are held together by hydrogen bonds formed between the nucleotide bases.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 57 - Which of the following features is least commonly seen in Gitelman’s syndrome? ...

    Incorrect

    • Which of the following features is least commonly seen in Gitelman’s syndrome?

      Your Answer:

      Correct Answer: Hypertension

      Explanation:

      Gitelman syndrome is an autosomal recessive kidney disorder characterized by hypokalaemia metabolic alkalosis with hypocalciuria, and hypomagnesemia. In contrast to patients with Gordon’s syndrome, those suffering from Gitelman’s syndrome are generally normotensive or hypotensive.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 58 - Which one of the following is least associated with photosensitivity? ...

    Incorrect

    • Which one of the following is least associated with photosensitivity?

      Your Answer:

      Correct Answer: Acute intermittent porphyria

      Explanation:

      Sunlight, especially its ultraviolet radiation component, can cause increased or additional types of damage in predisposed individuals, such as those taking certain phototoxic drugs, or those with certain conditions associated with photosensitivity, including:- Psoriasis- Atopic eczema- Erythema multiforme- Seborrheic dermatitis- Autoimmune bullous diseases (immunobullous diseases)- Mycosis fungoides- Smith–Lemli–Opitz syndrome- Porphyria cutanea tardaAlso, many conditions are aggravated by strong light, including:- Systemic lupus erythematosus- Sjögren’s syndrome- Sinear Usher syndrome- Rosacea- Dermatomyositis- Darier’s disease- Kindler-Weary syndromeAcute intermittent porphyria (AIP) belongs to the group inborn errors of metabolism and most patients with AIP are not light sensitive.

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      0
      Seconds

  • Question 59 - The following can cause steatorrhea except ...

    Incorrect

    • The following can cause steatorrhea except

      Your Answer:

      Correct Answer: Diseases that destroy the endocrine portion of the pancreas

      Explanation:

      Dietary fats and lipids are usually efficiently digested and over 90% absorbed. Impaired digestion or absorption can result in fatty stools. Possible causes include exocrine (not endocrine) pancreatic insufficiency, with poor digestion from lack of lipases, loss of bile salts, which reduces micelle formation, and small intestinal disease producing malabsorption. Various other causes including certain medicines that block fat absorption, or indigestible or excess oil/fat in diet.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 60 - A 85 year old male with a history of Alzheimer's dementia was brought...

    Incorrect

    • A 85 year old male with a history of Alzheimer's dementia was brought into Casualty by family members, who stated that he had episodes of aggression. Which of the following drugs is most suitable as the pharmacological management for this presentation?

      Your Answer:

      Correct Answer: Risperidone

      Explanation:

      Regarding the pharmacological management, Risperidone is the most suitable drug from the given answers as it is recommended for the treatment of aggression associated with moderate to severe Alzheimer’s disease. Quetiapine and Benzodiazepine are not recommended.

    • This question is part of the following fields:

      • Geriatrics
      • Medicine
      0
      Seconds

  • Question 61 - Which of the following may be a feature of primary hyperaldosteronism? ...

    Incorrect

    • Which of the following may be a feature of primary hyperaldosteronism?

      Your Answer:

      Correct Answer: Muscular weakness

      Explanation:

      Primary hyperaldosteronism or Conn’s syndrome is characterised by hypertension which may cause poor vision or headaches. Occasionally there may be muscular weakness, muscle spasms, tingling sensations, or excessive urination. Complications include cardiovascular disease such as stroke, myocardial infarction, kidney failure, and abnormal heart rhythms.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 62 - Treatment of an acute attack of gout with allopurinol may result in which...

    Incorrect

    • Treatment of an acute attack of gout with allopurinol may result in which of the following?

      Your Answer:

      Correct Answer: Exacerbation and prolongation of the attack

      Explanation:

      Initiation of allopurinol treatment during an attack can exacerbate and prolong the episode. Thus treatment should be delayed until the attack resolves.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 63 - A 65-year-old man, after suffering from a pathological rib fracture, complains of recurrent...

    Incorrect

    • A 65-year-old man, after suffering from a pathological rib fracture, complains of recurrent infection. Bone marrow aspiration revealed a calcium level of 3.9 mmol/l and alkaline phosphatase level of 160u/l. What type of cell would be found in abundance in the marrow spear?

      Your Answer:

      Correct Answer: Plasma cells

      Explanation:

      Multiple myeloma or plasma cell myeloma, is a cancer of plasma cells, responsible for producing antibodies. It often, presents early with no symptoms followed by bone pain and pathological fractures (metastases), raised calcium levels, bleeding, frequent infections, and anaemia. It usually occurs around the age of 61 and is more common in men than women.

    • This question is part of the following fields:

      • Geriatrics
      • Medicine
      0
      Seconds

  • Question 64 - Regarding taste threshold and intensity discrimination: ...

    Incorrect

    • Regarding taste threshold and intensity discrimination:

      Your Answer:

      Correct Answer: 30% change in concentration of substance tasted is necessary before an intensity difference can be detected

      Explanation:

      The ability of humans to differentiate differences in intensity of taste is poor. A 30% change in the concentration of the substance being tasted is required before an intensity difference is perceived.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 65 - The process where by DNA fragments are separated by size and charge is...

    Incorrect

    • The process where by DNA fragments are separated by size and charge is called:

      Your Answer:

      Correct Answer: Gel electrophoresis

      Explanation:

      Fragments of DNA of varying length can be separated on the basis of their charge and their size by a process called gel electrophoresis. Because DNA contains negatively charged phosphate groups, it will migrate in an electric field toward the positive electrode. Shorter chains migrate more rapidly through the pores of the gel, and thus separation depends on length. DNA bands in the gel can be visualized by various techniques including staining with dyes and autoradiography.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 66 - Regarding Iron stores, which of the following contains the highest proportion of total...

    Incorrect

    • Regarding Iron stores, which of the following contains the highest proportion of total body iron?

      Your Answer:

      Correct Answer: Haemoglobin

      Explanation:

      Most well-nourished people in industrialized countries have 4 to 5 grams of iron in their bodies. Of this, about 2.5 g is contained in the haemoglobin needed to carry oxygen through the blood, and most of the rest (approximately 2 grams in adult men, and somewhat less in women of childbearing age) is contained in ferritin complexes that are present in all cells, but most common in bone marrow, liver, and spleen.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 67 - A 50-year-old male was brought to the ER after the accidental consumption of...

    Incorrect

    • A 50-year-old male was brought to the ER after the accidental consumption of 300 ml of diethylene glycol. Blood investigations were suggestive of metabolic acidosis and renal failure. What is the appropriate management in this patient?

      Your Answer:

      Correct Answer: Haemodialysis and oral ethanol

      Explanation:

      Among the given options the most appropriate management in this patient would be ethanol and haemodialysis.Ethanol competes with ethylene glycol for alcohol dehydrogenase and thus, helps manage a patient with ethylene glycol toxicity.Ethylene glycol is a type of alcohol used as a coolant or antifreezeFeatures of toxicity are divided into 3 stages:Stage 1: (30 min to 12 hours after exposure) Symptoms similar to alcohol intoxication: confusion, slurred speech, dizziness (CNS depression)Stage 2: (12 – 48 hours after exposure) Metabolic acidosis with a high anion gap and high osmolar gap. Also tachycardia, hypertensionStage 3: (24 – 72 hours after exposure) Acute renal failureManagement has changed in recent times:Fomepizole, an inhibitor of alcohol dehydrogenase, is now used first-line in preference to ethanol.Ethanol has been used for many years works by competing with ethylene glycol for the enzyme alcohol dehydrogenase this limits the formation of toxic metabolites (e.g. glycolaldehyde and glycolic acid) which are responsible for the hemodynamic/metabolic features of poisoning.Haemodialysis has a role in refractory cases.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 68 - Cross-bridges between actin and myosin filaments contain: ...

    Incorrect

    • Cross-bridges between actin and myosin filaments contain:

      Your Answer:

      Correct Answer: Calcium ions

      Explanation:

      At rest troponin I is bound to actin and tropomyosin and covers the site where the myosin head interacts with actin. When calcium enters into the muscle, it binds with troponin C and causes a structural change in troponin I which moves out of the myosin binding site and causes the cross bridges between the actin and myosin filaments to occur.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 69 - A 50-year-old male presents to the ER allegedly claiming that he consumed a...

    Incorrect

    • A 50-year-old male presents to the ER allegedly claiming that he consumed a bottle of antifreeze. Which of the following symptoms is least likely to be associated with this kind of poisoning?

      Your Answer:

      Correct Answer: Hypertension

      Explanation:

      Loss of vision after consumption of antifreeze is a characteristic presentation of methanol poisoning.

      Pathophysiology of methanol toxicity: When ingested, methanol is absorbed rapidly via the gastrointestinal tract in less than 10 minutes. Methanol is not protein-bound and is absorbed directly into the total body water compartment. Metabolism occurs mainly in the liver through serial oxidation via alcohol dehydrogenase and aldehyde dehydrogenase but begins with alcohol dehydrogenase present in the gastric mucosa. Alcohol dehydrogenase oxidizes methanol to formaldehyde, and aldehyde dehydrogenase subsequently oxidizes formaldehyde to formic acid. Formic acid is the primary toxic metabolite that accounts for the associated anion gap metabolic acidosis and end-organ damage.

      Clinical presentation: Patients who present within the first 12 to 24 hours following ingestion may appear normal, and this is described as the latent period. Nausea, vomiting, and abdominal pain subsequently ensue, followed by CNS depression and hyperventilation due to metabolic acidosis. Ocular symptoms associated with retinal toxicity are often evident in the form of blurry vision, decreased visual acuity, photophobia, and “halo vision.”

      Treatment: Treatment options for methanol toxicity include supportive care, fomepizole (Antizole, 4-Methylpyrazole or 4MP), ethanol, dialysis, and folate.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 70 - A patient has been diagnosed with multi-drug resistant tuberculosis and is currently bring...

    Incorrect

    • A patient has been diagnosed with multi-drug resistant tuberculosis and is currently bring treated with rifampicin, isoniazid, and pyrazinamide. He is commenced on streptomycin.Which among the following is the most likely neurological side-effect of streptomycin?

      Your Answer:

      Correct Answer: Vestibular damage

      Explanation:

      Vestibular damage is a neurological side effect of streptomycin.Streptomycin is an aminoglycoside bactericidal antibiotic. It is used in the treatment of tularaemia and resistant mycobacterial infections.The most common neurological side-effect is vestibular damage leading to vertigo and vomiting. Cochlear damage is less frequent and results in deafness. Other side-effects include rashes, angioneurotic oedema, and nephrotoxicity.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 71 - 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

  • Question 72 - Neurogenesis occurs throughout life in the following two areas: ...

    Incorrect

    • Neurogenesis occurs throughout life in the following two areas:

      Your Answer:

      Correct Answer: Hippocampus and striatum

      Explanation:

      In humans, neurogenesis or new neurons are continually born during adulthood in two regions of the brain: The subgranular zone (SGZ), part of the dentate gyrus of the hippocampus and the striatum. In other species of mammals, adult-born neurons also appear in the olfactory bulb. In humans, however, few if any olfactory bulb neurons are generated after birth.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 73 - The cerebellum consist of which three lobes? ...

    Incorrect

    • The cerebellum consist of which three lobes?

      Your Answer:

      Correct Answer: Anterior, posterior and flocculonodular

      Explanation:

      The cerebellum consists of 3 lobes; Anterior, Posterior and Flocculonodular lobe.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 74 - Cell mediating innate immunity include: ...

    Incorrect

    • Cell mediating innate immunity include:

      Your Answer:

      Correct Answer: Natural killer cells

      Explanation:

      Antigen receptors recognize the shape of the antigen. They identify specific epitopes and are found on T cells.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 75 - Which of the following is not innervated by the parasympathetic nerve supply? ...

    Incorrect

    • Which of the following is not innervated by the parasympathetic nerve supply?

      Your Answer:

      Correct Answer: Radial muscle of iris

      Explanation:

      The sphincter pupillae is supplied by the parasympathetic fibers from the Edinger Westphal nucleus of the oculomotor nerve. The dilator pupillae (radial muscle) is supplied by the postganglionic fibers of the superior cervical sympathetic ganglion. The parasympathetic nerve supply to the salivary glands originate in the parasympathetic nucleus of the facial nerve (superior salivatory nucleus) and the glossopharyngeal nerve (inferior salivatory nucleus). The parasympathetic preganglionic fibers originate in the dorsal nucleus of the vagus nerve and descend into the thorax in the vagus nerve. The fibers terminate by synapsing with postganglionic neurons in the cardiac plexuses. Postganglionic fibers terminate on the sinoatrial and atrioventricular nodes and on the coronary arteries Parasympathetic supply to the stomach is via the vagus nerve.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 76 - The coronary sinus, which empties into the right atrium, serves to? ...

    Incorrect

    • The coronary sinus, which empties into the right atrium, serves to?

      Your Answer:

      Correct Answer: Drain the venous supply of the myocardium

      Explanation:

      The coronary sinus is a collection of veins joined together to form a large vessel that collects blood from the heart muscle (myocardium). It delivers deoxygenated blood to the right atrium, as do the superior and inferior vena cava.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 77 - Presence of which of the following indicates a worse prognosis in rheumatoid arthritis?...

    Incorrect

    • Presence of which of the following indicates a worse prognosis in rheumatoid arthritis?

      Your Answer:

      Correct Answer: Anti-CCP antibodies

      Explanation:

      Rheumatoid arthritis is both common and chronic, with significant consequences for multiple organ systems. Anti-cyclic citrullinated peptide (anti-CCP) antibody testing is particularly useful in the diagnosis of rheumatoid arthritis, with high specificity, presence early in the disease process, and ability to identify patients who are likely to have severe disease and irreversible damage. However, its sensitivity is low, and a negative result does not exclude disease. Anti-CCP antibodies have not been found at a significant frequency in other diseases to date, and are more specific than rheumatoid factor for detecting rheumatoid arthritis. The other factors that are mentioned do not play a key prognostic role.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 78 - In the absence of insulin: ...

    Incorrect

    • In the absence of insulin:

      Your Answer:

      Correct Answer: Glucose uptake by most of the brain is normal

      Explanation:

      Although it is known that insulin levels affect glucose uptake, oxidation and storage in peripheral tissues, its role in the brain isn’t as clear. However, studies have shown that bulk brain glucose uptake isn’t affected by insulin. Glucose transport into the neurons is GLUT3 dependent, and its transport into glia and brain endothelial cells rely on GLUT1. Insulin isn’t necessary for GLUT1 or GLUT3, which explains why brain glucose uptake isn’t affected by insulin levels.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 79 - In the event of an overdose, haemodialysis is ineffective as a treatment modality...

    Incorrect

    • In the event of an overdose, haemodialysis is ineffective as a treatment modality for which of the following drugs?

      Your Answer:

      Correct Answer: Tricyclics

      Explanation:

      Tricyclic compounds can’t be cleared by haemodialysis.Drugs that can be cleared with haemodialysis include: (BLAST)- Barbiturate- Lithium- Alcohol (inc methanol, ethylene glycol)- Salicylates- Theophyllines (charcoal hemoperfusion is preferable)Drugs which cannot be cleared with haemodialysis include:- Tricyclics- Benzodiazepines- Dextropropoxyphene (Co-proxamol)- Digoxin- Beta-blockers

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 80 - A 50-year-old hypertensive male on phenytoin and clobazam for partial seizures is also...

    Incorrect

    • A 50-year-old hypertensive male on phenytoin and clobazam for partial seizures is also taking lisinopril, cimetidine, sucralfate, and allopurinol. The last few drugs were added recently. He now presents with ataxia, slurred speech, and blurred vision.Which recently added drug is most likely to be the cause of his latest symptoms?

      Your Answer:

      Correct Answer: Cimetidine

      Explanation:

      The symptoms of ataxia, slurred speech and blurred vision are all suggestive of phenytoin toxicity. Cimetidine increases the efficacy of phenytoin by reducing its hepatic metabolism.Phenytoin has a narrow therapeutic index (10-20 mg/L) and its levels are monitored by measuring the total phenytoin concentration.Cimetidine is an H2 receptor antagonist used in the treatment of peptic ulcers. It acts by decreasing gastric acid secretion.Cimetidine also has an inhibitory effect on several isoforms of the cytochrome enzyme system including the CYP450 enzymatic pathway. Phenytoin is metabolized by the same cytochrome P450 enzyme system in the liver. Thus, the simultaneous administration of both these medications leads to an inhibition of phenytoin metabolism and thus increases its circulating levels leading to phenytoin toxicity.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
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  • Question 81 - Which glucose transporter is responsible for the uptake of dietary glucose from the...

    Incorrect

    • Which glucose transporter is responsible for the uptake of dietary glucose from the gut?

      Your Answer:

      Correct Answer: SGLT1

      Explanation:

      SGLT 1 is responsible for the uptake of glucose via secondary active transport from the small intestine and the renal tubules.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 82 - Select the correct statement regarding the macro anatomy of the thyroid gland. ...

    Incorrect

    • Select the correct statement regarding the macro anatomy of the thyroid gland.

      Your Answer:

      Correct Answer: It surrounds the trachea at the front of the neck.

      Explanation:

      The thyroid is located around the trachea, in the anterior portion of the neck. It is formed by two lobes which are connected by an isthmus. The presence of a pyramidal lobe, or third lobe, is considered to be a normal anatomical variant. It originates from the primitive pharynx and the neural crest and has a rich vascular supply.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
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      Seconds

  • Question 83 - What is the function of the acute phase protein, C-reactive protein? ...

    Incorrect

    • What is the function of the acute phase protein, C-reactive protein?

      Your Answer:

      Correct Answer: Opsonises bacteria

      Explanation:

      There are various immune reactions that become activated once the barrier between the body and environment has been compromised. There are certain opsonins that bind to the bacteria and facilitate phagocytosis. One of them is the acute phase protein: C protein. others include antibodies and complement.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 84 - Why does arterial blood pressure drop during pregnancy? ...

    Incorrect

    • Why does arterial blood pressure drop during pregnancy?

      Your Answer:

      Correct Answer: Progesterone relaxes vascular smooth muscle

      Explanation:

      Progesterone relaxes vascular smooth muscle thus resulting In a decrease in total peripheral resistance. This accounts for the increase in the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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      Seconds

  • Question 85 - Which of the following factors is most likely to lead to an increase...

    Incorrect

    • Which of the following factors is most likely to lead to an increase in serum cortisol levels?

      Your Answer:

      Correct Answer: Severe emotional stress

      Explanation:

      Cortisol is widely known as the stress hormone. Alterations in cortisol levels have been found in relation to mood disorders, illness, trauma, pain, fear, exertion, and anxiety, amongst other stimuli.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 86 - During anaerobic glycolysis, the net production of ATP is: ...

    Incorrect

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

      Your Answer:

      Correct 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
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      Seconds

  • Question 87 - In a 60kg adult male with normal mean arterial pressure and oxygen consumption,...

    Incorrect

    • In a 60kg adult male with normal mean arterial pressure and oxygen consumption, what proportion of the cardiac output at rest goes to the brain?

      Your Answer:

      Correct Answer: 10-15%

      Explanation:

      The rate of cerebral blood flow in the adult is typically 750 millilitres per minute, which is 10-15% of the cardiac output. On average around 13.9% of cardiac output is distributed to the brain.

    • This question is part of the following fields:

      • Medicine
      • Neurology
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      Seconds

  • Question 88 - Which of the following limits the duration of inspiration and increases respiratory rate?...

    Incorrect

    • Which of the following limits the duration of inspiration and increases respiratory rate?

      Your Answer:

      Correct Answer: Pneumotaxic centre

      Explanation:

      The mechanism of control of ventilation is an interplay of multiple regions in the brain. The medullary respiratory centre sets the basic rhythm of breathing and the pons modifies the output of the medullary centres. There are two pontine centres: apneustic and pneumotaxic.

      The pnuemotaxic centre controls inspiratory time. Increased signals to this area increases respiratory rate. The dorsal respiratory group (DRG) integrates input from the stretch receptors and the chemoreceptors in the periphery and is composed mainly of inspiratory neurons. The DRG controls the basic rhythm of breathing by triggering inspiratory impulses. The ventral respiratory group (VRG) generates breathing rhythm and integrates data coming into the medulla and contains both inspiratory and expiratory neurons. They are primarily active in exercise and stress.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
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  • Question 89 - Which of the following occurs during a Valsalva manoeuvre? ...

    Incorrect

    • Which of the following occurs during a Valsalva manoeuvre?

      Your Answer:

      Correct Answer: An initial rise in blood pressure

      Explanation:

      The Valsalva maneuver involves forced expiration against a closed glottis. It has several phases, each affecting the cardiovascular system differently:

      1. Phase I: During the initial forced expiration against the closed glottis, there is a transient rise in intrathoracic pressure, which compresses the thoracic aorta and causes a brief increase in blood pressure.
      2. Phase II: Continued straining leads to decreased venous return to the heart, reducing cardiac output and causing a drop in blood pressure. This phase is characterized by a compensatory increase in heart rate.
      3. Phase III: Upon releasing the strain, there is a sudden drop in intrathoracic pressure, which momentarily decreases blood pressure.
      4. Phase IV: Blood pressure then rises rapidly as venous return to the heart is restored, leading to increased cardiac output. This is often followed by a reflex bradycardia (slow heart rate).

      Given these phases, the most accurate statement about what occurs during the Valsalva maneuver is the initial rise in blood pressure (Phase I).

      Other options explained:

      • Forced inspiration against a closed glottis: Incorrect. The Valsalva maneuver involves forced expiration, not inspiration, against a closed glottis.
      • Low intrathoracic pressures throughout: Incorrect. The Valsalva maneuver involves high intrathoracic pressures due to forced expiration.
      • Disruption of autonomic function: Incorrect. The Valsalva maneuver affects autonomic function but does not disrupt it. Instead, it triggers autonomic responses to changes in blood pressure and heart rate.
      • No change: Incorrect. The Valsalva maneuver causes significant changes in blood pressure and heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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      Seconds

  • Question 90 - Complement system help dispose waste products after which natural process? ...

    Incorrect

    • Complement system help dispose waste products after which natural process?

      Your Answer:

      Correct Answer: Apoptosis

      Explanation:

      The complement system is a part of the immune system that enhances (complements) the ability of antibodies and phagocytic cells to clear microbes and damaged cells from an organism or apoptosis. It is part of the innate immune system.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 91 - Which of the following forms an important constituent of the brush border on...

    Incorrect

    • Which of the following forms an important constituent of the brush border on the microvilli of the intestinal epithelium?

      Your Answer:

      Correct Answer: Hydrolases

      Explanation:

      There are certain enzymes which are part of the brush border cells including hydrolases also known as the brush border hydrolases. They perform the final step in digestion of certain nutrients.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 92 - Chief cells secrete: ...

    Incorrect

    • Chief cells secrete:

      Your Answer:

      Correct Answer: Pepsinogen and gastric lipase

      Explanation:

      A gastric chief cell (or peptic cell, or gastric zymogenic cell) is a type of cell in the stomach that releases pepsinogen and gastric lipase.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 93 - Which of the following would be the most appropriate treatment (leaving out the...

    Incorrect

    • Which of the following would be the most appropriate treatment (leaving out the current NICE guidelines) for a 29 year old man with erythrodermic psoriasis and arthritis mutilans involving several digits of both hands?

      Your Answer:

      Correct Answer: Etanercept

      Explanation:

      TNF-alpha inhibitors are known to ameliorate the symptoms and disease activity of Arthritis mutilans (a rare and severe form of psoriatic arthritis), by disabling the cytokines that are involved in inflammation and joint destruction. From the mentioned choices, this would be the most effective option. Methotrexate is the most commonly used DMARD, followed by sulfasalazine used in mild to moderate forms of psoriatic arthritis but has not shown much efficacy in arthritis mutilans. Phototherapy, narrowband UVB light therapy can be very effective in clearing skin lesions.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
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      Seconds

  • Question 94 - Which statement about the 2nd heart sound is true? ...

    Incorrect

    • Which statement about the 2nd heart sound is true?

      Your Answer:

      Correct Answer: It is caused by closure of the aortic and pulmonary valves.

      Explanation:

      The second heart sound is produced due to closure of the aortic and pulmonary valves. It is a high pitched dub sound.

      Normally the aortic closure sound (A2) occurs prior to the pulmonic closure sound (P2), and the interval between the two (splitting) widens on inspiration and narrows on expiration. With quiet respiration, A2 will normally precede P2 by 0.02 to 0.08 second (mean, 0.03 to 0.04 sec) with inspiration. In younger subjects inspiratory splitting averages 0.04 to 0.05 second during quiet respiration. With expiration, A2 and P2 may be superimposed and are rarely split as much as 0.04 second. If the second sound is split by greater than 0.04 second on expiration, it is usually abnormal. Therefore, the presence of audible splitting during expiration (i.e., the ability to hear two distinct sounds during expiration) is of greater significance at the bedside in identifying underlying cardiac pathology than is the absolute inspiratory increase in the A2–P2 interval.

      The respiratory variation of the second heart sound can be categorized as follows: (1) normal (physiologic) splitting; (2) persistent (audible expiratory) splitting, with normal respiratory variation; (3) persistent splitting without respiratory variation (fixed splitting); and (4) reversed (paradoxical) splitting.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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      Seconds

  • Question 95 - Which of the following concerning PR interval is INCORRECT? ...

    Incorrect

    • Which of the following concerning PR interval is INCORRECT?

      Your Answer:

      Correct Answer: Always measured from the beginning of p wave to the beginning of r wave

      Explanation:

      The PR interval measures the time from the start of atrial depolarization to the start of ventricular depolarization. The PR interval is only measured from the beginning of P wave to beginning of R wave if the Q wave is absent.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 96 - Regarding cardiac muscle contractility, the afterload refers to: ...

    Incorrect

    • Regarding cardiac muscle contractility, the afterload refers to:

      Your Answer:

      Correct Answer: The resistance against which blood is expected

      Explanation:

      The afterload for the left ventricle is the aortic pressure. Hence it is this pressure that offers resistance against which the blood is to be expelled from the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 97 - Which is primarily responsible for the conversion of T4 to T3 in the...

    Incorrect

    • Which is primarily responsible for the conversion of T4 to T3 in the periphery?

      Your Answer:

      Correct Answer: Deiodinase 1

      Explanation:

      Type 1 iodothyronine deiodinase, also known simply as deiodinase 1, is an enzyme which can produce both triiodothyronine (active form) or inactivate metabolites from T4. It is responsible for almost 80% of the conversion of peripheral T4 to T3. Iodothyronine deiodinases are not to be confused with iodotyrosine deiodinases, which are also part of the deiodinase enzymes.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 98 - 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 99 - An important hormone controlling the differentiation of monocytes to osteoclasts, by inhibiting the...

    Incorrect

    • An important hormone controlling the differentiation of monocytes to osteoclasts, by inhibiting the RANKL/ RANK interaction is called?

      Your Answer:

      Correct Answer: Osteoprotegerin

      Explanation:

      Osteoprotegerin, also known as osteoclastogenesis inhibitory factor (OCIF) is a glycoprotein that acts as a cytokine receptor. It works as a decoy receptor for the receptor activator of nuclear factor-kappaB ligand (RANKL)/osteoclast differentiation factor, thus inhibiting the differentiation of osteoclasts, which are capable of resorbing bone. Osteoprotegerin has been proposed as a therapeutic agent for osteoporosis.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 100 - What is the mechanism of action of sumatriptan? ...

    Incorrect

    • What is the mechanism of action of sumatriptan?

      Your Answer:

      Correct Answer: 5-HT1 agonist

      Explanation:

      Triptans are specific 5-HT1 agonists used in the acute treatment of migraine. They are generally used as first-line therapy in combination with an NSAID or paracetamol.

      Sumatriptan acts as an agonist on 5-HT1B/1D receptors by inducing vasoconstriction in the basilar artery and blood vessels within the dura mater. The drug reduces peripheral nociception either by selective cranial vasoconstriction or by affecting trigeminovascular nerves.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Genetics (3/3) 100%
Medicine (13/15) 87%
Connective Tissue (2/2) 100%
Cardiovascular (1/1) 100%
Neurology (4/4) 100%
Endocrinology (1/1) 100%
Haematology (1/3) 33%
Gastrointestinal (1/1) 100%
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