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Question 1
Correct
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When is the blood pressure at its lowest during pregnancy?
Your Answer: Second trimester
Explanation:It is lowest during the second trimester.
Previous studies have reported changes in blood pressure (BP) throughout pregnancy, and it was generally accepted that in clinically healthy pregnant women, BP falls gradually at first trimester, reaching the lowest around 22–24 weeks, rising again from 28 weeks, and reaching preconception levels by 36 weeks of gestation
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 2
Incorrect
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Which of the following has the shortest duration:
Your Answer: PR interval
Correct Answer: Atrial systole
Explanation:Atrial systole: 0.1s
Atrial diastole: around 0.4s
Ventricular diastole: 0.4-0.53s
Ventricular systole: 0.27s
PR interval: 0.12-0.2 s
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 3
Incorrect
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On which chromosome is the gene for insulin located?
Your Answer: Chromosome 19
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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 4
Incorrect
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Currents caused by opening of which of the following channels contribute to the repolarization phase of the action potential of the ventricular muscle fibers?
Your Answer: Calcium channels
Correct Answer: Potassium channels
Explanation:Depolarization occurs due to opening of the voltage gated sodium channels. Repolarization occurs due to opening of the voltage gates potassium channels causing an out flux of potassium ions, decreasing the membrane potential towards resting potential.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 5
Correct
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Which of the following do not pass through the cavernous sinus?
Your Answer: CN 2
Explanation:Oculomotor nerve (N3), trochlear nerve (N4), ophthalmic and mandibular divisions of the trigeminal nerve (N5) pass along its lateral border. The abducent nerve (N6) passes through it along with the internal carotid artery.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 6
Incorrect
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In the basal ganglia, the Lentiform nucleus is formed by which two nuclei?
Your Answer: Globus pallidus and substantia nigra
Correct Answer: Putamen and Globus pallidus
Explanation:The Basal Ganglia are composed of the following structures: Caudate, putamen, Globus pallidus, subthalamic nucleus and substantia nigra.
The Lentiform nucleus is a biconvex structure located within the basal ganglia of the brain. It is composed of two nuclei:
- Putamen: This is the outer part of the Lentiform nucleus and is involved in regulating movements and various types of learning.
- Globus pallidus: This is the inner part of the Lentiform nucleus and is divided into two segments: the external segment (GPe) and the internal segment (GPi). It plays a key role in the regulation of voluntary movement.
These two structures together form the Lentiform nucleus, which is an integral part of the basal ganglia system involved in motor control.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 7
Correct
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A 35-year-old female has been recently diagnosed with hypertension. She's sexually active and is not using any birth control other than barrier method. Which among the following antihypertensives is contraindicated in this patient?
Your Answer: Lisinopril
Explanation:Among the following hypertensives, lisinopril (an ACE inhibitor) is contraindicated in patients who are planning for pregnancy.Per the NICE guidelines, when treating the woman in question, she should be treated as if she were pregnant given the absence of effective contraception. ACE inhibitors such as lisinopril are known teratogens and most be avoided.Drugs contraindicated in pregnancy:AntibioticsTetracyclinesAminoglycosidesSulphonamides and trimethoprimQuinolonesOther drugs:ACE inhibitors, angiotensin II receptor antagonistsStatinsWarfarinSulfonylureasRetinoids (including topical)Cytotoxic agentsThe majority of antiepileptics including valproate, carbamazepine, and phenytoin are known to be potentially harmful.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 8
Incorrect
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A 23 year old male patient presents with urethritis for the last 2 weeks that has not responded to antibiotics. Lately he has developed an onset of new range of symptoms that are linked to his HLA B27 positivity. Which of the following signs is not related to Reiter's syndrome?
Your Answer: Conjunctivitis
Correct Answer: A mild fever with a generalised macular rash
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. Dermatologic manifestations include skin lesions of the glans resembling psoriasis (balanitis circinata); hyperkeratinisation of the palms and soles (keratoderma blenorrhagicum)
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 9
Incorrect
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The areas of extensive series of sarcoplasmic folds known as intercalated discs always occur at what portion of the muscle fiber?
Your Answer: I band
Correct Answer: Z lines
Explanation:The muscle fibers of the heart branch and interdigitate, but one complete unit is surrounded by a cell membrane. The place where one muscle fiber abuts the other, the cell membrane of both the fibers run parallel to each other through a series of extensive folds. These areas always occur on the Z lines and are known as intercalated discs.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 10
Correct
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Which enzyme is responsible for the removal of acetylcholine from the synapse?
Your Answer: Acetylcholinesterase
Explanation:Acetylcholinesterase is the enzyme that is responsible for breaking down acetylcholine into choline and acetate. Both of these molecules are transported back to the presynaptic neuron to be synthesized again. This enzyme is attached to the collagen fibers of the basement membrane in the synaptic cleft.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 11
Correct
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Which heart sounds are matched correctly?
Your Answer: All of the above
Explanation:In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4. S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. S4 when audible in an adult is called a presystolic gallop or atrial gallop. This gallop is produced by the sound of blood being forced into a stiff or hypertrophic ventricle.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 12
Incorrect
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Erythropoietin is synthesized by which cells of the nephron?
Your Answer: Glomerular epithelial cells
Correct Answer: Tubular interstitial cells
Explanation:Erythropoietin is produced by interstitial fibroblasts in the kidney in close association with peritubular capillary and proximal convoluted tubule. It is also produced in perisinusoidal cells in the liver. While liver production predominates in the fetal and perinatal period, renal production is predominant during adulthood.
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This question is part of the following fields:
- Medicine
- Renal
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Question 13
Correct
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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.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 14
Incorrect
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Arterioles stemming from the coronary artery can also empty into the heart directly via the:
Your Answer: All arterioles empty into the coronary sinus or anterior cardiac vein
Correct Answer: Arteriosinusoidal vessels
Explanation:Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins. Apart from these there are other vessels that drain directly into the heart chambers. They include arteriosinusoidal vessels, which connect the arterioles to the heart chambers. The thebesian veins drain the capillaries into the chambers and the arterioluminal vessels drain small arteries directly into the chambers.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 15
Incorrect
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Cholesterol is synthesized in all of these organs EXCEPT?
Your Answer: Adrenal cortex
Correct Answer: Stomach
Explanation:The liver primarily synthesizes about 20-25% of the total daily cholesterol. Cholesterol is also synthesized to smaller extents in the adrenal glands, reproductive organs (as cholesterol is the precursor of sex hormones), skin and is also produced in the intestines.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 16
Correct
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ADH causes?
Your Answer: Increased permeability of the collecting ducts to water
Explanation:Vasopressin (ADH) has three main effects:1. Increasing the water permeability of distal convoluted tubule and collecting duct cells in the kidney, thus allowing water reabsorption and excretion of more concentrated urine.2. Increasing permeability of the inner medullary portion of the collecting duct to urea by regulating the cell surface expression of urea transporters.3. Acute increase of sodium absorption across the ascending loop of Henle.
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This question is part of the following fields:
- Medicine
- Renal
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Question 17
Correct
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What is the primary problem of achalasia
Your 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 18
Incorrect
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The interstitium of the kidney is most hypertonic in the:
Your Answer: Outer cortex
Correct Answer: Papillary tip of the medulla
Explanation:The medullary interstitium is the tissue surrounding the loop of Henle in the renal medulla. It functions in renal water reabsorption by building up a high hypertonicity, which draws water out of the thin descending limb of the loop of Henle and the collecting duct system. This hypertonicity, in turn, is created by an efflux of urea from the inner medullary collecting duct.
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This question is part of the following fields:
- Medicine
- Renal
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Question 19
Incorrect
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The following products of the vascular endothelium produce vasodilation except:
Your Answer: Nitrous oxide
Correct Answer: Endothelin
Explanation:Endothelin: This is incorrect in the context of vasodilation. Endothelin is actually a potent vasoconstrictor produced by the endothelium, leading to the narrowing of blood vessels and increased blood pressure.
Nitrous oxide (Nitric oxide): This is correct for vasodilation. Nitric oxide is a powerful vasodilator produced by the endothelium, which helps relax and widen blood vessels.
Prostacyclin: This is correct for vasodilation. Prostacyclin (PGI2) is a vasodilator and inhibits platelet aggregation, helping to maintain blood flow and reduce clot formation.
Endothelial-derived hyperpolarizing factor (EDHF): This is correct for vasodilation. EDHF causes vasodilation by hyperpolarizing the smooth muscle cells of blood vessels.
Vascular endothelial growth factor (VEGF): This is correct for vasodilation. VEGF primarily promotes the growth of new blood vessels but also has vasodilatory effects through nitric oxide production.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 20
Incorrect
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Where is most of the filtered sodium reabsorbed?
Your Answer: Thick ascending loop of Henle
Correct Answer: Proximal tubule
Explanation:Renal reabsorption of sodium (Na+) is a part of renal physiology. It uses Na-H antiport, Na-glucose symport, sodium ion channels (minor). It is stimulated by angiotensin II and aldosterone, and inhibited by atrial natriuretic peptide. Most of the reabsorption (65%) occurs in the proximal tubule.
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This question is part of the following fields:
- Medicine
- Renal
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Question 21
Incorrect
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The complex twisting and folding of peptide chains describes which order of protein structure?
Your Answer: Quaternary structure
Correct Answer: Secondary structure
Explanation:Secondary Structure refers to the coiling or folding of a polypeptide chain that gives the protein its 3-D shape. There are two types of secondary structures: the alpha (α) helix and the beta (β) pleated sheet.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 22
Incorrect
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Number of cases that are infected at a specific point in time
Your Answer: Pandemic
Correct Answer: Prevalence
Explanation:Prevalence in epidemiology is the proportion of a population found to have a condition (typically a disease or a risk factor such as smoking or seat-belt use). It is arrived at by comparing the number of people found to have the condition with the total number of people studied, and is usually expressed as a fraction, as a percentage or as the number of cases per 10,000 or 100,000 people. Point prevalence is the proportion of a population that has the condition at a specific point in time. Period prevalence is the proportion of a population that has the condition at some time during a given period (e.g., 12 month prevalence), and includes people who already have the condition at the start of the study period as well as those who acquire it during that period. Lifetime prevalence (LTP) is the proportion of a population that at some point in their life (up to the time of assessment) have experienced the condition
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 23
Incorrect
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The position of the kidneys besides the vertebral column retroperitoneally spans levels:
Your Answer: T10 – L1
Correct Answer: T12 – L3
Explanation:The asymmetry within the abdominal cavity, caused by the position of the liver, typically results in the right kidney being slightly lower and smaller than the left, and being placed slightly more to the middle than the left kidney. The left kidney is approximately at the vertebral level T12 to L3, and the right is slightly lower.
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This question is part of the following fields:
- Medicine
- Renal
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Question 24
Incorrect
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The rate of depolarisation of the sinus node membrane potential is modulated by all the following except:
Your Answer: Hypoxia
Correct Answer: Cardiac output
Explanation:Cardiac output has no effect on the depolarization of the pacemaker potential of the heart.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 25
Incorrect
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The following is true about the carotid arterial supply to the brain:
Your Answer: Direct union with the vertebral artery forms the circle of Willis
Correct Answer: Following carotid occlusion, precapillary anastomoses are unable to prevent infarction
Explanation:The brain has two sources of blood supply; the internal carotid arteries which are the anterior segment or the main artery that supplies the anterior portion of the brain, and the vertebral arteries which is the posterior segment which supplies the posterior portion of the brain. The internal carotid arteries branch and form two major arteries anterior and middle cerebral arteries. The right and left vertebral arteries fuse together at the level of the pons on the anterior surface of the brainstem to form the midline basilar artery. The basilar artery joins the blood supply from the internal carotids in an arterial ring at the base of the brain called the circle of Willis. The anterior and posterior communicating arteries conjoin the two major sources of cerebral vascular supply via the circle of Willis improving the chances of any region of the brain continuing to receive blood if one of the major arteries becomes occluded.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 26
Incorrect
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Regarding the innervation of the cerebral blood vessels, postganglionic sympathetic neurons have their cell bodies in the:
Your Answer: Inferior cervical ganglia
Correct Answer: Superior cervical ganglia
Explanation:The superior cervical ganglion (SCG) is a part of autonomic system which plays a major role in maintaining homeostasis of the body. This ganglion innervates structures in the head and neck and is the largest and the most superiorly located ganglion. The SCG provides sympathetic innervation to structures within the head, including the pineal gland, the blood vessels in the cranial muscles and the brain, the choroid plexus, the eyes, the lacrimal glands, the carotid body, the salivary glands, and the thyroid gland. The postganglionic axons of the SCG innervate the internal carotid artery and form the internal carotid plexus. The internal carotid plexus carries the postganglionic axons of the SCG to the eye, lacrimal gland, mucous membranes of the mouth, nose, and pharynx, and numerous blood-vessels in the head.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 27
Incorrect
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What is cardiac output?
Your Answer: Product of cardiac output and peripheral resistance
Correct Answer: Product of stroke volume and heart rate
Explanation:Cardiac output is the product of stroke volume and heart rate.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 28
Incorrect
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A 30-year-old female presents with a 4-day history of diarrhoea and vomiting. She has been unable to keep fluids down for 4 days and has been treated with metoclopramide. She develops a dystonic reaction. What is the most appropriate treatment for this woman?
Your Answer: Flupentixol
Correct Answer: Benztropine
Explanation:Acute dystonic reactions (extrapyramidal symptoms) such as spasmodic torticollis, trismus, and oculogyric crises can occur following the administration of metoclopramide or stemetil and thus, neither is recommended for the treatment of nausea in young women.
Such reactions respond well to treatment with benztropine or procyclidine.
– Benztropine: It is an anticholinergic medication with significant CNS penetration. A single dose of benztropine 1 to 2 mg IV followed by 1 to 2 mg p.o twice a day for up to 7 days to prevent a recurrence. Subsequently, both the offending agent and those from the same group should be avoided.
– Alternatively, diphenhydramine can be used intravenously (up to a dose of 50mg) or intramuscularly followed by p.o therapy every 6 hours for 1 to 2 to prevent a recurrence.- Second-line therapy with IV benzodiazepines is reserved for those patients who do not respond to anticholinergics.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 29
Incorrect
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Which of the following refers to the process of decoding messenger RNA into an amino acid sequence?
Your Answer: Replication
Correct Answer: Translation
Explanation:Messenger RNA (mRNA) is decoded in a ribosome, outside the nucleus, to produce a specific amino acid chain, or polypeptide. This is known as translation and follows after the process transcription of DNA to RNA in the cell’s nucleus.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 30
Incorrect
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Which of the following is not secreted by cells in the antrum of the stomach?
Your Answer: Somatostatin
Correct Answer: Hydrochloric acid
Explanation:Cells in the body of the stomach secrete mucus, HCl and pepsinogen. Cells in the antrum secrete pepsinogen, gastrin and mucus.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 31
Correct
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Initial depolarization of cardiac muscle is due to influx of:
Your Answer: Na+
Explanation:Initial depolarization of the cardiac muscle results from opening of the sodium voltage gated channels. This results in the influx of sodium and an increase in the membrane potential towards threshold. Potassium efflux results in repolarization.
The cardiac action potential has 5 phases:
- Phase 0—depolarization because of the opening of fast sodium channels. Potassium flux also decreases.
- Phase 1—partial repolarization because of a rapid decrease in sodium ion passage as fast sodium channels close.
- Phase 2—plateau phase in which the movement of calcium ions out of the cell, maintains depolarization.
- Phase 3—repolarization, sodium, and calcium channels all close and membrane potential returns to baseline.
- Phase 4—resting membrane potential (−90 mV), resulting from the activity of the Na+/K+ ATPase pump which creates a negative intracellular potential because of the exchange of three sodium ions for only two potassium ions.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 32
Correct
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A 22-year-old female comes to you for counselling regarding the initiation of combined oral contraceptive pill. Which of the following statements is correct?
Your Answer: She will still be protected against pregnancy if she takes amoxicillin for a lower respiratory tract infection while on the combined pill
Explanation:The true statement among the given options is that she will still be protected against pregnancy if she takes amoxicillin for a lower respiratory tract infection while on the combined pill.Other than enzyme-inducing antibiotics such as rifampicin, antibiotics do not reduce the efficacy of the combined oral contraceptive pill.It was previously advised that barrier methods of contraception should be used if taking an antibiotic while using the contraceptive pill, due to concerns that antibiotics might reduce the absorption of the pill. This is now known to be untrue. However, if the absorptive ability of the gut is compromised for another reason, such as severe diarrhoea or vomiting, or bowel disease, this may affect the efficacy of the pill.The exception to the antibiotic rule is that hepatic enzyme-inducing antibiotics such as rifampicin and rifaximin do reduce the efficacy of the pill. Other enzyme-inducing drugs, such as phenytoin, phenobarbital, carbamazepine or St John’s Wort can also reduce the effectiveness of the pill.Other options:The combined pill is often prescribed for women with heavy periods as it can make them lighter and less painful. There is no evidence that women on the combined pill put on any significant weight, although they may experience bloating at certain times in the course. Women on the pill require monitoring of their blood pressure. There are multiple different types of combined pills.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 33
Incorrect
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A clinical trial is conducted to study the benefits of a new oral medication to improve the symptoms of patients with asthma. In the trial 400 patients with asthma, half were given the new medication and half a placebo. Three months later they are asked to rate their symptoms using the following scale: much improved, slight improvement, no change, slight worsening, significantly worse. What is the most appropriate statistical test to see whether the new medication is beneficial?
Your Answer: Student's t-test (unpaired)
Correct Answer: Mann-Whitney U test
Explanation:The type of significance test used depends on whether the data is parametric (can be measured, usually normally distributed) or non-parametric.Parametric tests:Student’s t-test – paired or unpaired*Pearson’s product-moment coefficient – correlationNon-parametric tests:Mann-Whitney U test – unpaired dataWilcoxon signed-rank test – compares two sets of observations on a single samplechi-squared test – used to compare proportions or percentagesSpearman, Kendall rank – correlation.The outcome measured is not normally distributed, i.e. it is non-parametric. This excludes the Student’s t-tests. We are not comparing percentages/proportions so the chi-squared test is excluded. The Mann–Whitney U test is a nonparametric test of the null hypothesis that it is equally likely that a randomly selected value from one sample will be less than or greater than a randomly selected value from a second sample.This test can be used to investigate whether two independent samples were selected from populations having the same distribution.
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This question is part of the following fields:
- Medicine
- Research Skills
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Question 34
Correct
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One of the cells of the bone marrow that are responsible for forming the various forms of differentiated blood cells are called?
Your Answer: Hematopoietic stem cell
Explanation:Hematopoietic stem cells (HSCs) or hemocytoblasts are the stem cells that give rise to all the other blood cells through the process of haematopoiesis. They are derived from mesoderm and located in the red bone marrow, which is contained in the core of most bones.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 35
Incorrect
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The postextrasystolic potentiation of myocardial contractility is due to:
Your Answer: Increased ventricular filling
Correct Answer: Increase in intracellular Ca2+
Explanation:The postextrasystolic potentiation of myocardial contractility Is not due to ventricular filling. It occurs in isolated locations in the heart and is due to increase availability of intracellular calcium.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 36
Incorrect
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With regards to the deiodinases, where would you find D1?
Your Answer: Brown fat
Correct Answer: Liver
Explanation:The liver produces an important amount of T3 by outer ring deiodination thanks to its elevated concentration of type I deiodinase. It can also be found in the kidney.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 37
Incorrect
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In the cardiac cycle, all of the following are true except:
Your Answer: The ‘a’ is due to atrial systole
Correct Answer: Mitral valve is closed by contraction of papillary muscles
Explanation:Mitral valve is closed by contraction of papillary muscles: This statement is incorrect. The mitral valve closes due to the pressure difference between the left ventricle and the left atrium at the onset of ventricular systole. The papillary muscles contract to prevent prolapse of the valve into the atrium but do not cause the valve to close.
The left ventricular volume is maximal at the end of atrial systole: This statement is true. At the end of atrial systole, the atria have pushed the remaining blood into the ventricles, making the ventricular volume maximal (end-diastolic volume).
The left ventricular pressure is maximal just before the aortic valve opens: This statement is true. Left ventricular pressure peaks just before the aortic valve opens, as the ventricle contracts to overcome the pressure in the aorta.
The ejection fraction is about 55%: This statement is true. The ejection fraction, which is the percentage of blood ejected from the ventricles with each contraction, is typically around 55%.
The ‘a’ wave is due to atrial systole: This statement is true. The ‘a’ wave on the venous pressure curve corresponds to atrial systole, reflecting the increased pressure from atrial contraction.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 38
Correct
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Inhibition of cell division at the end of G1 occurs through:
Your Answer: Unphosphorolated retinoblastoma protein (uRb)
Explanation:A cell’s decision to enter, or re-enter, the cell cycle is made before S-phase in G1 at what is known as the restriction point, and is determined by the combination of promotional and inhibitory extracellular signals that are received and processed. Ultimately unphosphorylated Rb acts as an inhibitor of G1.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 39
Incorrect
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With regards to the cell cycle, which phase represents period of cell growth that divides the end of DNA synthesis and the beginning of somatic cell division?
Your Answer: S Phase
Correct Answer: Gap 2
Explanation:Interphase is divided into three phases: G1 (first gap), S (synthesis), and G2 (second gap). During all three parts of interphase, the cell grows by producing proteins and cytoplasmic organelles. However, chromosomes are replicated only during the S phase. Thus, a cell grows (G1), continues to grow as it duplicates its chromosomes (S), grows more and prepares for mitosis (G2), and finally divides (M) before restarting the cycle.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 40
Incorrect
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The following are Gram-negative cocci:
Your Answer: Staphylococcus
Correct Answer: Neisseria
Explanation:Gram-negative cocci include the four types that cause a sexually transmitted disease (Neisseria gonorrhoeae), a meningitis (Neisseria meningitidis), and respiratory symptoms (Moraxella catarrhalis, Haemophilus influenzae).
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 41
Incorrect
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The pathway responsible for the discriminative aspect of pain, is called the:
Your Answer: Palaeospinothalamic tract
Correct Answer: Neospinothalamic tract
Explanation:The spinothalamic tract is an ascending or a sensory tract, responsible for transmission of pain and temperature. The neospinothalamic tract is responsible for fast pain or discriminative pain whereas the palaeospinothalamic tract is responsible for transmission of slow pain.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 42
Correct
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The following are examples of the functions of the vascular endothelium except:
Your Answer: Tumour suppression
Explanation:Vascular endothelium has many important functions including regulation of vascular tone, molecular exchange between blood and tissue compartments, hemostasis and signaling for the immune regulation and inflammation. Depending on specific tissue needs and local stresses, endothelial cells are capable of evoking either antithrombotic or prothrombotic events. Tumor suppression is related to genes, or anti-oncogenes, that regulate a cell during cell division and replication.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 43
Correct
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Which vitamin is found in NAD and NADP?
Your Answer: Vitamin B3
Explanation:In organisms, NAD can be synthesized from simple building-blocks (de novo) from the amino acids tryptophan or aspartic acid. In an alternative fashion, more complex components of the coenzymes are taken up from food as the vitamin called niacin (vitamin B3)
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This question is part of the following fields:
- Haematology
- Medicine
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Question 44
Correct
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Which caspase is part of both the intrinsic and extrinsic apoptotic pathways?
Your Answer: Caspase-3
Explanation:Once initiator caspases are activated in both the intrinsic and extrinsic pathway, they produce a chain reaction, activating several other executioner caspases (Caspase 3, Caspase 6 and Caspase 7).
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 45
Correct
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Which lipoprotein is responsible for lowering of plasma lipids?
Your Answer: HDL
Explanation:High-density lipoproteins (HDL) are one of the five major groups of lipoproteins. Lipoproteins are complex particles composed of multiple proteins which transport all fat molecules (lipids) around the body within the water outside cells. Unlike the larger lipoprotein particles which deliver fat molecules to cells, HDL particles remove fat molecules from cells.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 46
Incorrect
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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: Prednisolone
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.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 47
Incorrect
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The alpha amylases hydrolyse which linkages in the ingested polysaccharides?
Your Answer: 1:6α linkages
Correct Answer: 1:4α linkages
Explanation:Alfa amylase hydrolyses the α (1-4) glyosidic bonds in amylose and amylopectin and leave primarily maltose.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 48
Incorrect
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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: A further 6 months warfarin, target INR 2 - 3
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.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 49
Correct
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The transporter responsible for most glucose absorption in the lumen of the small intestine is called?
Your Answer: SGLT 1
Explanation:GLUT = Glucose transporter. GLUT are a family of proteins of different types. GLUT 1 is mainly expressed in erythrocytes, whereas GLUT 2 is mainly expressed by, liver cells and renal tubular cells. GLUT 5 is a sucrose transporter in enterocytes. SGLT- Sodium-dependent glucose cotransporter or sodium-glucose linked transporter are a family of proteins of different types. SGLT1 transporter is found in the intestinal mucosa of the small intestine and SGLT2 in the proximal tubule of the nephron.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 50
Correct
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Myocyte action potentials – Choose the false statement:
Your Answer: Repolarisation is due to net k+ influx
Explanation:Final repolarization (phase 3) to the resting membrane potential (phase 4) is due to closure of the Ca2+ channels and a slow, delayed increase of K+ efflux through various types of K+ channels.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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