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  • Question 1 - Where is the myenteric plexus (Auerbach’s plexus) located in the GIT? ...

    Incorrect

    • Where is the myenteric plexus (Auerbach’s plexus) located in the GIT?

      Your Answer: In the lumen

      Correct Answer: Between the outer longitudinal and middle circular muscle layers.

      Explanation:

      A part of the enteric nervous system, the myenteric plexus exists between the longitudinal and circular layers of muscularis externa in the gastrointestinal tract. It is found in the muscles of the oesophagus, stomach, and intestine.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      8.3
      Seconds
  • Question 2 - The complex twisting and folding of peptide chains describes which order of protein...

    Correct

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

      Your 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
      13.1
      Seconds
  • Question 3 - Which of the following drugs is NOT bacteriostatic? ...

    Correct

    • Which of the following drugs is NOT bacteriostatic?

      Your Answer: Penicillin

      Explanation:

      Bactericidal antibiotics kill bacteria directly whereas bacteriostatic antibiotics slow their growth or reproduction. Tetracycline is a bacteriostatic antibiotic. Erythromycin which is a macrolide is mainly a bacteriostatic antibiotic but can show bactericidal action depending on the dose. Sulphonamides are mainly bacteriostatic. Penicillin inhibits cell wall synthesis therefore it is considered as bactericidal. Chloramphenicol is primarily a bacteriostatic antibiotic which inhibits protein synthesis and can exhibit bactericidal action in high concentrations.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      19.6
      Seconds
  • Question 4 - Which of the following stimulates glucagon release? ...

    Correct

    • Which of the following stimulates glucagon release?

      Your 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
      3
      Seconds
  • Question 5 - An 81-year-old male presented to the emergency department following a fall at home....

    Incorrect

    • An 81-year-old male presented to the emergency department following a fall at home. He was diagnosed with osteoporosis about five years ago. He presently complains of significant low back pain. A lumbar spine X-ray was suggestive of a fractured lumbar vertebra. A subsequent MRI scan of the lumbosacral spine revealed a new L3 burst fracture with no evidence of cord compression. A neurosurgical consult was sought and conservative management was planned accordingly in the form of pain control, physiotherapy, and mobilization (as allowed by the pain). He also has been diagnosed with chronic renal disease (stage IV) with a creatinine clearance of 21ml/min, he was started on a Buprenorphine patch. Which of the following opioids would be safest to use for his breakthrough pain?

      Your Answer: Morphine

      Correct Answer: Oxycodone

      Explanation:

      Oxycodone is a safer opioid to use in patients with moderate to end-stage renal failure.Active metabolites of morphine accumulate in renal failure which means that long-term use is contraindicated in patients with moderate/severe renal failure. These toxic metabolites can accumulate causing toxicity and risk overdose. Oxycodone is mainly metabolised in the liver and thus safer to use in patients with moderate to end-stage renal failure with dose reductions.Adverse effects:Constipation is the most common overall side effect. Others include: asthenia, dizziness, dry mouth, headache, nausea, pruritus, etc. Medications in renal failure:Drugs to be avoided in patients with renal failureAntibiotics: tetracycline, nitrofurantoinNSAIDsLithiumMetforminDrugs that require dose adjustment:Most antibiotics including penicillin, cephalosporins, vancomycin, gentamicin, streptomycinDigoxin, atenololMethotrexateSulphonylureasFurosemideOpioidsRelatively safe drugs:Antibiotics: erythromycin, rifampicinDiazepamWarfarin

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      40.5
      Seconds
  • Question 6 - Preload: ...

    Correct

    • Preload:

      Your Answer: Is the degree to which the myocardium is stretched before is contracts

      Explanation:

      Preload is end diastolic volume. It is the degree to which the heart muscle fiber is stretched when it fills up completely just before the heart contracts.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      45.6
      Seconds
  • Question 7 - Which of the following is NOT a cause of onycholysis? ...

    Correct

    • Which of the following is NOT a cause of onycholysis?

      Your Answer: Mycoplasma pneumonia

      Explanation:

      Onycholysis is the separation of the distal edge of the nail from the vascular nailbed causing whiteness of the free edge. Causes include:- Idiopathic- Trauma, excessive manicuring- Infection: especially fungal- Skin disease: psoriasis, dermatitis- Impaired peripheral circulation e.g. Raynaud’s- Systemic disease: hyper/hypothyroidism, reactive arthritis, porphyria cutanea tarda- Sometimes a reaction to detergents (e.g. washing dishes with bare hands, using detergent-based shampoos or soaps).- Patients with hepatocellular dysfunction may develop hair-thinning or hair loss and nail changes such as clubbing, leukonychia (whitening), or onycholysis.

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      4.6
      Seconds
  • Question 8 - Myocardium requires more oxygen to expel blood in: ...

    Correct

    • Myocardium requires more oxygen to expel blood in:

      Your Answer: A stenotic aortic valve

      Explanation:

      In aortic valve stenosis, increased ventricular pressure Is needed to expel the blood into the aorta. Increased pressure means increased contractility hence increase O2 consumption by the heart muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      253.6
      Seconds
  • Question 9 - Where are the cell bodies to the preganglionic neurons located? ...

    Correct

    • Where are the cell bodies to the preganglionic neurons located?

      Your Answer: Midbrain

      Explanation:

      The cell bodies of the preganglionic neurons are located in the lateral grey column of the spinal cord and in the motor nuclei of the 3rd, 7th, 9th and 10th cranial nerves. These cranial nerves take origin from the midbrain.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      10.1
      Seconds
  • Question 10 - HLA class III genes encode for ...

    Correct

    • HLA class III genes encode for

      Your Answer: Complement

      Explanation:

      HLAs corresponding to MHC class III encode components of the complement system.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      6.5
      Seconds
  • Question 11 - Lymphoid stem cells give rise to the following cells: ...

    Correct

    • Lymphoid stem cells give rise to the following cells:

      Your 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
      6.4
      Seconds
  • Question 12 - Which one of the following conditions is least likely to be associated with...

    Incorrect

    • Which one of the following conditions is least likely to be associated with pyoderma gangrenosum?

      Your Answer: Rheumatoid arthritis

      Correct Answer: Syphilis

      Explanation:

      The following are conditions commonly associated with pyoderma gangrenosum:

      Inflammatory bowel disease:

      • Ulcerative colitis
      • Crohn’s disease

      Arthritides:

      • Rheumatoid arthritis
      • Seronegative arthritis

      Haematological disease:

      • Myelocytic leukaemia
      • Hairy cell leukaemia
      • Myelofibrosis
      • Myeloid metaplasia
      • Monoclonal gammopathy

      Autoinflammatory disease:

      • Pyogenic sterile arthritis, pyoderma gangrenosum, and acne syndrome (PAPA syndrome)
      • Granulomatosis with polyangiitis

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      5.7
      Seconds
  • Question 13 - Cell membrane proteins may act as: ...

    Correct

    • Cell membrane proteins may act as:

      Your Answer: All of the options

      Explanation:

      Membrane proteins perform a variety of functions including:Membrane receptor proteins relay or carry signals between the cell’s internal and external environments.Transport proteins move molecules and ions (ionic channels) across the membrane. Membrane enzymes may have many activities, such as oxidoreductase, transferase or hydrolase andCell adhesion molecules

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      7.1
      Seconds
  • Question 14 - Where is the M1 receptor mainly found? ...

    Correct

    • Where is the M1 receptor mainly found?

      Your Answer: Sympathetic postganglionic neurons

      Explanation:

      M1 receptors are found in the sympathetic postganglionic neurons.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      5.6
      Seconds
  • Question 15 - A 67 year old man reports weight loss. Labs show a raised alkaline...

    Incorrect

    • A 67 year old man reports weight loss. Labs show a raised alkaline phosphatase at 290 U/L (normal range 35-120). Plain radiographs reveal sclerotic lesions of the bone. Which of the following is the most likely cause of these findings?

      Your Answer: Multiple myeloma

      Correct Answer: Prostate cancer

      Explanation:

      Osteoblastic (or sclerotic) bony metastases, characterized by deposition of new bone, present in prostate cancer, carcinoid, small cell lung cancer, Hodgkin lymphoma or medulloblastoma. The other cancers listed in the options are osteolytic.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      13.7
      Seconds
  • Question 16 - What is the mechanism of action of carbimazole? ...

    Correct

    • What is the mechanism of action of carbimazole?

      Your Answer: Inhibition of the iodination of tyrosine

      Explanation:

      Carbimazole is used to treat hyperthyroidism. Carbimazole is a pro-drug as after absorption it is converted to the active form, methimazole. Methimazole prevents thyroid peroxidase enzyme from coupling and iodinating the tyrosine residues on thyroglobulin, hence reducing the production of the thyroid hormones T3 and T4 (thyroxine).

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      6
      Seconds
  • Question 17 - Into how many functional units can the cerebellum be divided? ...

    Correct

    • Into how many functional units can the cerebellum be divided?

      Your Answer: 3

      Explanation:

      The functional division of the cerebellum are the: Vestibulocerebellum (floculonodular lobe), Spinocerebellum (vermis and associated areas in the midline) and cerebrocerebellum (lateral hemispheres).

    • This question is part of the following fields:

      • Medicine
      • Neurology
      5.1
      Seconds
  • Question 18 - Which glucose transporter is responsible for the uptake of glucose in ß cells?...

    Correct

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

      Your 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
      9.7
      Seconds
  • Question 19 - The cavernous sinus is? ...

    Incorrect

    • The cavernous sinus is?

      Your Answer: Medial to the body of the mastoid

      Correct Answer: Lateral to the body of the sphenoid

      Explanation:

      It is a venous sinus which creates a cavity called the lateral sellar compartment bordered by the temporal bone and the sphenoid bone. There are 2 on either side. It is about 1cm wide and extends from the posterior aspect of the orbit to the petrous part of the temporal bone. They sit on either side or lateral to the sphenoid bone.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      8.2
      Seconds
  • Question 20 - Regarding oxidative deamination of amino acids, which of the following is true? ...

    Correct

    • Regarding oxidative deamination of amino acids, which of the following is true?

      Your Answer: Occurs in the kidney & liver

      Explanation:

      Oxidative deamination is a form of deamination that generates α-keto acids and other oxidized products from amine-containing compounds, and occurs largely in the liver and kidney. Oxidative deamination is an important step in the catabolism of amino acids, generating a more metabolizable form of the amino acid, and also generating ammonia as a toxic by-product. The addition of ubiquitin to a substrate protein is called ubiquitination.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      7.5
      Seconds
  • Question 21 - Which one of the following is least associated with photosensitivity? ...

    Incorrect

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

      Your Answer: Herpes labialis

      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
      10.2
      Seconds
  • Question 22 - Select the correct statement regarding the 4th heart sound, it? ...

    Incorrect

    • Select the correct statement regarding the 4th heart sound, it?

      Your Answer: Occurs after the second heart sound.

      Correct Answer: Can be heard in atrial systole.

      Explanation:

      The fourth heart sound is not normally audible in a normal adult. It occurs as a consequence of ventricular hypertrophy. It is caused by filling of the ventricle by atrial systole.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      22.3
      Seconds
  • Question 23 - A patient who has recently been diagnosed with SLE undergoes serum testing. A...

    Correct

    • A patient who has recently been diagnosed with SLE undergoes serum testing. A rise in which of the following antibodies would indicate severe systemic involvement?

      Your Answer: Anti double-stranded DNA antibodies

      Explanation:

      Anti ds-DNA antibodies are very specific for SLE and their presence most often indicates systemic spread of the disease. These antibodies are present in about 30 percent of the total cases of SLE.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      12.6
      Seconds
  • Question 24 - The transport of the di- and tri-peptides into enterocytes is by: ...

    Incorrect

    • The transport of the di- and tri-peptides into enterocytes is by:

      Your Answer: H+ dependent peptide transporter 2

      Correct Answer: H+ dependent peptide transporter 1

      Explanation:

      Peptides longer that four amino acids are not absorbed. There is abundant absorption of di and tri peptidases in the small intestine. They are absorbed into the epithelial cell of the small intestine via a transporter called Peptide Transporter 1 by co transport with H+ ions.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      11.3
      Seconds
  • Question 25 - A 47-year-old woman diagnosed with oestrogen receptor positive breast cancer three months ago...

    Correct

    • A 47-year-old woman diagnosed with oestrogen receptor positive breast cancer three months ago was started on treatment with tamoxifen. Which of the following is most likely a complaint of this patient during her review today?

      Your Answer: Hot flushes

      Explanation:

      The most likely complaint of this patient would be hot flushes.

      Alopecia and cataracts are listed as possible side-effects, however they are not as prevalent as hot flushes, which are very common in pre-menopausal women.

      Tamoxifen is a Selective Oestrogen Receptor Modulator (SERM) which acts as an oestrogen receptor antagonist and partial agonist. It is used in the management of oestrogen receptor-positive breast cancer

      Adverse effects:

      • Menstrual disturbance: vaginal bleeding, amenorrhoea
      • Hot flushes – 3% of patients stop taking tamoxifen due to climacteric side-effects.
      • Venous thromboembolism.
      • Endometrial cancer (although antagonistic with respects to breast tissue, tamoxifen may serve as an agonist at other sites. Therefore the risk of endometrial cancer is increased). Raloxifene is a pure oestrogen receptor antagonist and carries a lower risk of endometrial cancer.

      Tamoxifen is typically used for 5 years following the removal of the tumour.

       

       

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      26.1
      Seconds
  • Question 26 - Which of the following causes the closure of the ductus arteriosus during birth?...

    Correct

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

      Your 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
      6.9
      Seconds
  • Question 27 - A 25-year-old female presents to the emergency department with severe breathlessness and tinnitus....

    Correct

    • A 25-year-old female presents to the emergency department with severe breathlessness and tinnitus. She is under treatment for asthma and depression with albuterol and amitriptyline respectively.On examination, she seems agitated with a BP of 100/44, a pulse rate of 112 bpm, a respiratory rate of 30 cycles/min, and a temperature of 37.8'C.An arterial blood gas performed reveals:pH: 7.48 (7.36 – 7.44)pO2: 11.2 kPa (11.3 – 12.6 kPa)pCO2: 1.9 kPa (4.7 – 6.0 kPa)Bicarbonate: 13 mmol/l (20 – 28 mmol/L)What is the most probable diagnosis?

      Your Answer: Salicylate poisoning

      Explanation:

      The blood gas analysis provided above is suggestive of a mixed respiratory alkalosis and metabolic acidosis characteristic of salicylate overdose.Pathophysiology:The direct stimulation of the cerebral medulla causes hyperventilation and respiratory alkalosis.As it is metabolized, it causes an uncoupling of oxidative phosphorylation in the mitochondria. Lactate levels then increase due to the increase in anaerobic metabolism. This, along with a slight contribution from the salicylate metabolites result in metabolic acidosis.Tinnitus is characteristic and salicylate ototoxicity may produce deafness. Other neurological sequelae include encephalopathy and agitation, seizures and CNS depression and coma. Cardiovascular complications include tachycardia, hypotension, and dysrhythmias (VT, VF, and asystole).

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      21.2
      Seconds
  • Question 28 - The thalamic nuclei that project over wide regions of the neocortex are: ...

    Correct

    • The thalamic nuclei that project over wide regions of the neocortex are:

      Your Answer: Specific relay nuclei

      Explanation:

      The thalamus is considered the relay station for sensory and motor stimuli. There are three basic types of thalamic nuclei: relay nuclei, association nuclei and non-specific nuclei. Relay nuclei receive very well defined inputs and project this signal to functionally distinct areas of the cerebral cortex. These include the nuclei that relay primary sensations and also the nuclei involved in feedback of cerebellar signals and basal gangliar output.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      6.7
      Seconds
  • Question 29 - What is the main function of vitamin E? ...

    Correct

    • What is the main function of vitamin E?

      Your Answer: It is an antioxidant

      Explanation:

      Vitamin E has many biological functions, the antioxidant function being the best known. Other functions include enzymatic activities, gene expression, and neurological function(s).

    • This question is part of the following fields:

      • Haematology
      • Medicine
      9.5
      Seconds
  • Question 30 - Amongst the following cells, which is responsible for the secretion of defensins? ...

    Correct

    • Amongst the following cells, which is responsible for the secretion of defensins?

      Your Answer: Neutrophils

      Explanation:

      Eosinophils are phagocytic and they are directed against helminths. Basophils are involved in allergic reactions and contain histamine and vasoactive granules in their cytoplasm. Mast cells are similar to basophils. Monocytes differentiate into macrophages in the tissue, secret interleukins and are phagocytic. Neutrophils are phagocytic but are also responsible for secreting defensins.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      5.1
      Seconds
  • Question 31 - Which of the following makes up the thick filaments in muscle fibers? ...

    Correct

    • Which of the following makes up the thick filaments in muscle fibers?

      Your Answer: Myosin

      Explanation:

      The thick filaments are made up of myosin and the thin filaments are made up of actin. The thick filaments are twice the size of the thin filaments and are aligned to form the A band. The thin filaments extending out from the A band form the less dense I bands.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.5
      Seconds
  • Question 32 - Afferent A δ fibers from nociceptors terminate primarily on neurons in which lamina:...

    Correct

    • Afferent A δ fibers from nociceptors terminate primarily on neurons in which lamina:

      Your Answer: I and V

      Explanation:

      Nociceptors are receptors of pain sensation. There are 2 primary afferent/sensory pain fibers which transmit impulses from the receptor to the CNS, specifically to the dorsal horn of the spinal cord. The two fibers are A δ and C fibers. The dorsal horn of the spinal cord is the relay centre for sensory information converging from the periphery. Grey matter of the dorsal horn is subdivided in to laminae based on cytoarchitecture. C fibers terminate in lamina II the substantia gelatinosa. A δ fibers terminate primarily in lamina I but some project more deeply to terminate in lamina V.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      3.1
      Seconds
  • Question 33 - Antibiotic resistance may happen by: ...

    Incorrect

    • Antibiotic resistance may happen by:

      Your Answer: By active expulsion of drug by nuclear efflux systems

      Correct Answer: By enzymes which inactivate the drug

      Explanation:

      The three main mechanisms of antibiotic resistance are, enzymatic degradation of antibacterial drugs, alteration of bacterial proteins that are antimicrobial targets, and changes in membrane permeability to antibiotics.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      10.3
      Seconds
  • Question 34 - Heart rate can be slowed by: ...

    Incorrect

    • Heart rate can be slowed by:

      Your Answer: Hypoxia

      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
      2.7
      Seconds
  • Question 35 - Where does one find the thyroid receptors? ...

    Incorrect

    • Where does one find the thyroid receptors?

      Your Answer: Rough endoplasmic reticulum

      Correct Answer: Cell nucleus

      Explanation:

      Unlike many of the steroid receptors, inactive receptors for T3 are located in the nucleus. T4 is first converted into T3 within the cytoplasm of the cell, T3 then enters the nucleus and binds to its receptor. The hormone-receptor complex can now bind to DNA and activate specific genes.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      4.7
      Seconds
  • Question 36 - Which neuron secretes glutamate as its neurotransmitter? ...

    Correct

    • Which neuron secretes glutamate as its neurotransmitter?

      Your Answer: A delta and C pain fibers

      Explanation:

      A delta and C fibers use glutamate as their primary neurotransmitter where it acts as a fast acting localized neurotransmitter.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      7.5
      Seconds
  • Question 37 - Relaxation of the cardiac muscle at the actin-myosin cross bridges is initiated by...

    Incorrect

    • Relaxation of the cardiac muscle at the actin-myosin cross bridges is initiated by binding of which molecule to the exposed site on the myosin.

      Your Answer: Calcium ATPase

      Correct Answer: ATP

      Explanation:

      A crossbridge is a myosin projection, consisting of two myosin heads, that extends from the thick filaments. Each myosin head has two binding sites: one for ATP and another for actin. The binding of ATP to a myosin head detaches myosin from actin, thereby allowing myosin to bind to another actin molecule. Once attached, the ATP is hydrolysed by myosin, which uses the released energy to move into the cocked position whereby it binds weakly to a part of the actin binding site.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19.1
      Seconds
  • Question 38 - Which of the following isoforms of Nitric oxide synthase (NOS) is found in...

    Incorrect

    • Which of the following isoforms of Nitric oxide synthase (NOS) is found in endothelial cells?

      Your Answer: Nos 2

      Correct Answer: Nos 3

      Explanation:

      There are only 3 isoforms:NOS 1: found in nervous systemNOS 2: in macrophages and other immune cellsNOS 3: In endothelial cells

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.3
      Seconds
  • Question 39 - Which of the following regulates the calcium release channels? ...

    Incorrect

    • Which of the following regulates the calcium release channels?

      Your Answer: Both a and d

      Correct Answer: Calstabin 2

      Explanation:

      Ca2+ is released from the SR through a Ca2+ release channel, a cardiac isoform of the ryanodine receptor (RyR2), which controls intracytoplasmic [Ca2+] and, as in vascular smooth-muscle cells, leads to the local changes in intracellular [Ca2+] called calcium sparks. A number of regulatory proteins, including calstabin 2, inhibit RyR2 and, thereby, the release of Ca2+ from the SR.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      9.6
      Seconds
  • Question 40 - A 25-year-old male presents to the emergency department with fever, sweating, hyperventilation and...

    Correct

    • A 25-year-old male presents to the emergency department with fever, sweating, hyperventilation and breathing difficulty. He also complains of a continuous ringing sensation in both his ears for the past couple of days. He admits to consuming a lot of over the counter painkillers for the past few days. Which of the following drugs is the most likely cause of these symptoms?

      Your Answer: Aspirin

      Explanation:

      The presence of tinnitus, fever and hyperventilation are clues for aspirin (salicylate) toxicity. Clinical Presentation of salicylate toxicity can include:• Pulmonary manifestations include: Hyperventilation, hyperpnea, severe dyspnoea due to noncardiogenic pulmonary oedema, fever and dyspnoea due to aspiration pneumonitis• Auditory symptoms caused by the ototoxicity of salicylate poisoning include: Hard of hearing and deafness, and tinnitus (commonly encountered when serum salicylate concentrations exceed 30 mg/dL).• Cardiovascular manifestations include: Tachycardia, hypotension, dysrhythmias – E.g., ventricular tachycardia, ventricular fibrillation, multiple premature ventricular contractions, asystole – with severe intoxication, Electrocardiogram (ECG) abnormalities – E.g., U waves, flattened T waves, QT prolongation may reflect hypokalaemia.• Neurologic manifestations include: CNS depression, with manifestations ranging from somnolence and lethargy to seizures and coma, tremors, blurring of vision, seizures, cerebral oedema – With severe intoxication, encephalopathy• GI manifestations include: Nausea and vomiting, which are very common with acute toxicity, epigastric pain, GI haemorrhage – More common with chronic intoxication, intestinal perforation, pancreatitis, hepatitis – Generally in chronic toxicity; rare in acute toxicity, Oesophageal strictures – Reported as a very rare delayed complication• Genitourinary manifestations include: Acute kidney injury (NSAID induced Nephropathy) is an uncommon complication of salicylate toxicity, renal failure may be secondary to multisystem organ failure.• Hematologic effects may include prolongation of the prothrombin and bleeding times and decreased platelet adhesiveness. Disseminated intravascular coagulation (DIC) may be noted with multisystem organ failure in association with chronic salicylate toxicity.• Electrolyte imbalances like: Dehydration, hypocalcaemia, acidaemia, Syndrome of inappropriate antidiuretic hormone secretion (SIADH), hypokalaemiaManagement of these patients should be done in the following manner:• Secure Airway, Breathing, and Circulation• Supportive therapy• GI decontamination• Urinary excretion and alkalization• Haemodialysis

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      8.5
      Seconds
  • Question 41 - The hepatic portal vein is a large vessel formed by which of the...

    Incorrect

    • The hepatic portal vein is a large vessel formed by which of the following veins?

      Your Answer: The right gastroepiploic vein.

      Correct Answer: All of the above

      Explanation:

      The portal vein is usually formed by the confluence of the superior mesenteric and splenic veins and also receives blood from the inferior mesenteric, gastric, and cystic veins.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      24.6
      Seconds
  • Question 42 - The spleen underlies which ribs? ...

    Incorrect

    • The spleen underlies which ribs?

      Your Answer: 8 through 12

      Correct Answer: 9 through 11

      Explanation:

      The spleen lies between the 9th and 11th ribs on the left hand side.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      9.4
      Seconds
  • Question 43 - Regarding carbohydrates absorption; ...

    Incorrect

    • Regarding carbohydrates absorption;

      Your Answer: Intestinal glucose absorption requires phosphorylation

      Correct Answer: Intestinal absorption of sugars is inhibited by the drug phlorizin

      Explanation:

      The main role of insulin is in the uptake of glucose from blood to tissues where it is metabolised. Glycose transporters in the intestines do not depend on the action of insulin. Phlorizin is a competitive inhibitor of SGLT1 and SGLT2 because it competes with glucose for the binding site, reducing intestinal and renal glucose transport.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      24.8
      Seconds
  • Question 44 - The ENaC Transporter occurs in which part of the renal tubule? ...

    Correct

    • The ENaC Transporter occurs in which part of the renal tubule?

      Your Answer: Collecting duct

      Explanation:

      The epithelial sodium channel (ENaC) is a membrane-bound ion channel that is selectively permeable to Na+ ions. It is involved primarily in the reabsorption of sodium ions at the collecting ducts of the kidney’s nephrons.

    • This question is part of the following fields:

      • Medicine
      • Renal
      2.6
      Seconds
  • Question 45 - Which of the following structures of the cardiac conduction system is located in...

    Incorrect

    • Which of the following structures of the cardiac conduction system is located in the right posterior portion of the interatrial septum?

      Your Answer: SA node

      Correct Answer: AV node

      Explanation:

      AV node is located at the right posterior portion of the interatrial septum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      16.1
      Seconds
  • Question 46 - Which part of the cerebellum is primarily responsible for interacting with the motor...

    Incorrect

    • Which part of the cerebellum is primarily responsible for interacting with the motor cortex and planning and programming movements?

      Your Answer: Flocculonodular lobe

      Correct Answer: Cerebrocerebellum

      Explanation:

      The cerebrocerebellum is the largest functional subdivision of the cerebellum, comprising of the lateral hemispheres and the dentate nuclei. It is involved in the planning and timing of movements, and in the cognitive functions of the cerebellum.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      18.9
      Seconds
  • Question 47 - The Na-K-2Cl co-transporter occurs in which part of the renal tubule? ...

    Incorrect

    • The Na-K-2Cl co-transporter occurs in which part of the renal tubule?

      Your Answer: Basolateral surface of proximal tubule

      Correct Answer: Apical surface of thick ascending limb

      Explanation:

      The Na-K-Cl cotransporter (NKCC) is a protein that aids in the active transport of sodium, potassium, and chloride into cells. In humans there are two isoforms of this membrane transport protein, NKCC1 and NKCC2. NKCC2 is specifically found in cells of the thick ascending limb of the loop of Henle and the macula densa in nephrons, the basic functional units of the kidney. Within these cells, NKCC2 resides in the apical membrane abutting the nephron’s lumen.

    • This question is part of the following fields:

      • Medicine
      • Renal
      3.9
      Seconds
  • Question 48 - On which chromosome is the gene for insulin located? ...

    Incorrect

    • On which chromosome is the gene for insulin located?

      Your Answer: Chromosome 6

      Correct Answer: Chromosome 11

      Explanation:

      Humans have 23 pairs of chromosomes, and usually, two pairs of copies of chromosome 11. It is one of the most complex, gene-rich chromosomes in the human genome, and it is associated with a number of diseases. Studies have shown they the human insulin gene is located on the short arm of chromosome 11.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      9.6
      Seconds
  • Question 49 - What is the fat called that serves as a considerable source of heat...

    Correct

    • What is the fat called that serves as a considerable source of heat in children?

      Your Answer: Brown adipose tissue

      Explanation:

      Brown adipose tissue, also known as BAT or brown fat, coforms the adipose tissue along with white adipose tissue (WAT) or white fat. While WAT is responsible for energy-storage, BAT is involved in thermogenesis and energy expenditure. It is more prevalent in children than in adults, and its activation during adolescence is associated to less weight gain and adiposity. BAT produces heat by non-shivering thermogenesis.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      4.3
      Seconds
  • Question 50 - A 62-year-old software developer with lung cancer is currently taking MST 30mg bd...

    Incorrect

    • A 62-year-old software developer with lung cancer is currently taking MST 30mg bd for pain relief. What dose of oral morphine solution should he be prescribed for breakthrough pain?

      Your Answer: 5 mg

      Correct Answer: 10 mg

      Explanation:

      The total daily morphine dose is 30 x 2 = 60 mg. Therefore, the breakthrough dose should be one-sixth of this, 10 mg.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      11.5
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Gastrointestinal (0/3) 0%
Medicine (28/50) 56%
Metabolism (1/1) 100%
Infectious Diseases (1/2) 50%
Endocrinology (3/5) 60%
Pharmacology (4/6) 67%
Cardiovascular (4/10) 40%
Dermatology (1/3) 33%
Neurology (6/8) 75%
Immunology (2/2) 100%
Haematology (2/3) 67%
Cell Biology (2/2) 100%
Connective Tissue (1/2) 50%
Hepatobiliary (0/1) 0%
Renal (1/2) 50%
Passmed