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  • Question 1 - Which is NOT a prognostic factor for patients with malignant melanoma? ...

    Correct

    • Which is NOT a prognostic factor for patients with malignant melanoma?

      Your Answer: Diameter of melanoma > 6 mm

      Explanation:

      Features that affect prognosis are tumour thickness in millimetres (Breslow’s depth – the deeper the Breslow thickness the poorer the prognosis.), depth related to skin structures (Clark level – the level of invasion through the dermis), type of melanoma, presence of ulceration, presence of lymphatic/perineural invasion, presence of tumour-infiltrating lymphocytes (if present, prognosis is better), location of lesion, presence of satellite lesions, and presence of regional or distant metastasis. Malignant melanoma tends to grow radially before entering a vertical growth phase. The diameter it reaches has not been found to be a prognostic factor.

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      329.1
      Seconds

  • Question 2 - Where is Müllerian inhibiting substance (MIS) secreted? ...

    Incorrect

    • Where is Müllerian inhibiting substance (MIS) secreted?

      Your Answer: Zona glomerulosa

      Correct Answer: Sertoli cells

      Explanation:

      Müllerian inhibiting substance, also known as Anti-Müllerian hormone (AMH) or Müllerian-inhibiting hormone (MIH) is a glycoprotein hormone which prevents the development of the Müllerian ducts into the uterus. Its production by Sertoli cells continues during childhood in males and decreases after puberty.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      10.1
      Seconds

  • Question 3 - The majority striatal neurons, called medium spiny neurons, utilizes which neurotransmitter? ...

    Incorrect

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

      Your Answer: Dopamine

      Correct 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
      11.2
      Seconds

  • Question 4 - A 52-year-old man has squamous-cell carcinoma of his lower lip. Which of the...

    Incorrect

    • A 52-year-old man has squamous-cell carcinoma of his lower lip. Which of the following is most likely to be a feature of this type of carcinoma?

      Your Answer: 5 year survival is poor

      Correct Answer: It is capable of metastasising via the lymphatics

      Explanation:

      Squamous-cell skin cancer usually presents as a hard lump with a scaly top but can also form an ulcer. Onset is often over months and it is more likely to spread to distant areas than basal cell cancer vie the lymphatics. The greatest risk factor is high total exposure to ultraviolet radiation from the Sun. Other risks include prior scars, chronic wounds, actinic keratosis, lighter skin, Bowen’s disease, arsenic exposure, radiation therapy, poor immune system function, previous basal cell carcinoma, and HPV infection. While prognosis is usually good, if distant spread occurs five-year survival is ,34%

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      34.8
      Seconds

  • Question 5 - 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: Renal impairment if the starting dose is > 300 mg/day

      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
      22.4
      Seconds

  • Question 6 - Regarding gustatory sensation: ...

    Incorrect

    • Regarding gustatory sensation:

      Your Answer: Fungiform papillae are rounded structures arranged in a v on the back of the tongue

      Correct Answer: The sensory taste buds on the anterior two-thirds of the tongue travel to the chorda tympani branch of the facial nerve

      Explanation:

      There are three morphologically distinct types of taste buds including; circumvallate, fungiform and foliate. Circumvallate are rounded structures arranged in a v on the back of the tongue. The posterior third travels to glossopharyngeal nerve.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      780.4
      Seconds

  • Question 7 - A 68 year old male, previously diagnosed with osteoarthritis presents to your clinic...

    Incorrect

    • A 68 year old male, previously diagnosed with osteoarthritis presents to your clinic with acute on chronic pain in his big toe. Past history is significant for hypertension for which he takes Bendroflumethiazide 5mg daily. Examination reveals an erythematous, red hot metatarsophalangeal joint that has a knobbly appearance. X-ray shows punched out bony cysts. Which of the following would be the most appropriate long term management for this patient?

      Your Answer: Advise dietary restriction of rich foods

      Correct Answer: Stop Bendroflumethiazide and substitute a calcium antagonist

      Explanation:

      The most likely diagnosis is chronic tophaceous gout, which is classically associated with chronic renal impairment or long term diuretic therapy. There is tophus formation due to urate crystal deposition in and around the joint. These tophi can also form in the bones and soft tissues. Renal manifestations with uric acid include nephrolithiasis and uric acid nephropathy. Whenever there is an acute on chronic attack of gout, the inciting cause must be established and in case of diuretic use, they should be immediately replaced with another medication. Allopurinol is never started during an acute episode. it is first allowed to settle before administration of allopurinol. Although dietary restriction must be observed in people with a propensity of gout, this scenario clearly presents diuretics as the cause.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      91.2
      Seconds

  • Question 8 - With regard to X linked disorders which of the following are true ...

    Incorrect

    • With regard to X linked disorders which of the following are true

      Your Answer: Females are never affected

      Correct Answer: X linked recessive disorders usually present in males and only very rarely present in homozygous females

      Explanation:

      All are true for autosomal recessive disorders. Dominance rules for sex-linked gene loci are determined by their behaviour in the female: because the male has only one allele (except in the case of certain types of Y chromosome aneuploidy), that allele is always expressed regardless of whether it is dominant or recessive.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      13.3
      Seconds

  • Question 9 - The principle by which the energy of contraction is proportional to the initial...

    Correct

    • The principle by which the energy of contraction is proportional to the initial length of cardiac muscle fiber is known as:

      Your Answer: Starling’s law

      Explanation:

      The Frank starling relationship describes that an increase in the venous return or the end diastolic volume will cause an increase in the stroke volume/ preload and also cardiac output. It stems from the fact that increase venous return will increase the stretch on the ventricular muscle fibers. The sarcomere will stretch a considerable length that is needed for maximum contraction and increased development of tension in the muscle fiber. The greater the venous return the greater the cardiac output. This relation is directly proportional.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      34.8
      Seconds

  • Question 10 - Consanguinity shows a strong association with which pattern of inheritance? ...

    Correct

    • Consanguinity shows a strong association with which pattern of inheritance?

      Your Answer: Autosomal recessive

      Explanation:

      Consanguinity involves being from the same kinship as another person. It is a common feature of an autosomal recessive mode of inheritance

    • This question is part of the following fields:

      • Genetics
      • Medicine
      13.1
      Seconds

  • Question 11 - A 55-year-old diabetic male presents with a feeling of generally being unwell. He...

    Incorrect

    • A 55-year-old diabetic male presents with a feeling of generally being unwell. He also has a history of atrial fibrillation and epilepsy. His main complaint is a blue tinge to his vision. Which one of his medications is most likely to be responsible?

      Your Answer: Phenytoin

      Correct Answer: Sildenafil

      Explanation:

      Blue tinge of vision/cyanopsia is caused due to the intake of sildenafil citrate.Sildenafil citrate (Viagra) is the first oral drug to be widely approved for the treatment of erectile dysfunction. It is a potent and selective inhibitor of type-V phosphodiesterase, the primary form of the enzyme found in human penile erectile tissue, thereby preventing the breakdown of cyclic guanosine monophosphate (cGMP), the intracellular second messenger of nitric oxide.Uses:It is used for the treatment of erectile dysfunction, idiopathic pulmonary hypertension, premature ejaculation, high altitude illness, penile rehabilitation after radical prostatectomy, angina pectoris, and lower urinary tract symptoms.Adverse effects:Mild headache, flushing, dyspepsia, cyanopsia, back pain, and myalgias – due to a high concentration of PDE11 enzyme in skeletal muscle, which shows significant cross-reactivity with the use of tadalafil.It can also cause hypotension, dizziness, and rhinitis.Note: Xanthopsia (yellow-green vision) may occur secondary to treatment with digoxin.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      55.6
      Seconds

  • Question 12 - The amount of a substance taken up by an organ (or whole body)...

    Correct

    • The amount of a substance taken up by an organ (or whole body) per unit time is = (the arterial level - the venous level) * the blood flow. This statement describes?

      Your Answer: The Fick principle

      Explanation:

      The essence of the Fick principle is that blood flow to an organ can be calculated using a marker substance if the following information is known:- Amount of marker substance taken up by the organ per unit time- Concentration of marker substance in arterial blood supplying the organ- Concentration of marker substance in venous blood leaving the organ

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      21.4
      Seconds

  • Question 13 - An example of cholinergic autonomic neurons are: ...

    Incorrect

    • An example of cholinergic autonomic neurons are:

      Your Answer: Sympathetic postganglionic neurons that decreases motility and tone of the stomach.

      Correct Answer: Sympathetic postganglionic neurons that innervate sweat glands.

      Explanation:

      All preganglionic neurons in both the sympathetic and parasympathetic nervous system secrete acetylcholine. The postganglionic neurotransmitter of the parasympathetic nervous system in all neurons is acetylcholine. Postganglionic fibers of the sympathetic nervous system mainly secrete Noradrenalin and Adrenalin but at sweat glands and erector pili muscles the postganglionic neurotransmitter is acetylcholine.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      49.2
      Seconds

  • Question 14 - Which of the following increase insulin secretion? ...

    Incorrect

    • Which of the following increase insulin secretion?

      Your Answer: 2- deoxyglucose

      Correct Answer: Sulfonylureas

      Explanation:

      Sulfonylureas are a type of antidiabetic drug used to treat diabetes mellitus type 2. Their main mechanism of action is producing a rise in plasma insulin levels, through stimulation of insulin secretion and a decrease in hepatic clearance of insulin. Sulfonylureas include gliclazide, glipizide, glibenclamide and glimepiride.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      19.7
      Seconds

  • Question 15 - Oxygen enters blood from the alveoli by: ...

    Correct

    • Oxygen enters blood from the alveoli by:

      Your Answer: Passive diffusion

      Explanation:

      Oxygen enters blood from the alveoli by simple diffusion along a concentration gradient. Concentration of oxygen and the partial pressure of oxygen in the alveoli are higher than the partial pressure of oxygen in the blood. So, oxygen moves from alveoli into blood via simple diffusion according to the concentration gradient.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      20
      Seconds

  • Question 16 - Regarding the length of systole and diastole which of the following is true?...

    Correct

    • Regarding the length of systole and diastole which of the following is true?

      Your Answer: The duration of systole is more fixed than diastole

      Explanation:

      The duration of systole is more fixed than the duration of diastole. When the heart rate increases the timing of systole remains more or less the same however, diastole decreases.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      43.2
      Seconds

  • Question 17 - The interstitium of the kidney is most hypertonic in the: ...

    Incorrect

    • The interstitium of the kidney is most hypertonic in the:

      Your Answer: Juxtaglomerular apparatus

      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.

    • This question is part of the following fields:

      • Medicine
      • Renal
      34.3
      Seconds

  • Question 18 - Immortality can result from over expression of which enzyme? ...

    Incorrect

    • Immortality can result from over expression of which enzyme?

      Your Answer: Ligase

      Correct Answer: Telomerase

      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.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      30.6
      Seconds

  • Question 19 - Normal parents have a child with a recessive condition, Tay Sachs. The chance...

    Incorrect

    • Normal parents have a child with a recessive condition, Tay Sachs. The chance of them having a normal child is?

      Your Answer: 25%

      Correct Answer: 75%

      Explanation:

      The chance for normal parents having a child with a recessive disease is 1:4 or 25%. As both the parents are heterozygous for this condition. They have a 3:4 chance of having a normal child or 75%.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      30
      Seconds

  • Question 20 - Endotoxin will typically act on which one of the following cells, to produce...

    Incorrect

    • Endotoxin will typically act on which one of the following cells, to produce endogenous pyrogens?

      Your Answer: B lymphocytes

      Correct Answer: Monocytes

      Explanation:

      Endotoxin, also known as lipopolysaccharides or lipoglycans, are molecules that consist of a lipid and a polysaccharide. They bind to many cell types, but especially to monocytes, promoting the secretion of proinflammatory cytokines, acting as a pyrogen.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      20.5
      Seconds

  • Question 21 - The following play a role in regulation of intestinal iron absorption except: ...

    Incorrect

    • The following play a role in regulation of intestinal iron absorption except:

      Your Answer: Recent dietary intake of iron

      Correct Answer: Urinary iron excretion rate

      Explanation:

      The human body’s rate of iron absorption appears to respond to a variety of interdependent factors, including total iron stores, dietary intake, the extent to which the bone marrow is producing new red blood cells, the concentration of haemoglobin in the blood, and the oxygen content of the blood. Classic examples of genetic iron overload includes hereditary hemochromatosis (HH) and the more severe disease juvenile hemochromatosis (JH).

    • This question is part of the following fields:

      • Haematology
      • Medicine
      28.1
      Seconds

  • Question 22 - Where is Vitamin B 12 absorbed? ...

    Incorrect

    • Where is Vitamin B 12 absorbed?

      Your Answer: Duodenum

      Correct Answer: Terminal ileum

      Explanation:

      Protein-bound vitamin B12 must be released from the proteins by the action of digestive proteases in both the stomach and small intestine. Gastric acid releases the vitamin from food particles; therefore antacid and acid-blocking medications (especially proton-pump inhibitors) may inhibit absorption of B12. B12 must be attached to Intrinsic Factor (IF) for it to be efficiently absorbed, as receptors on the enterocytes in the terminal ileum of the small bowel only recognize the B12-IF complex; in addition, intrinsic factor protects the vitamin from catabolism by intestinal bacteria.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      11.7
      Seconds

  • Question 23 - A deficiency in Cyanocobalamin leads to which clinical deficiency syndrome? ...

    Incorrect

    • A deficiency in Cyanocobalamin leads to which clinical deficiency syndrome?

      Your Answer: Scurvy

      Correct Answer: Pernicious anaemia

      Explanation:

      The main syndrome of vitamin B12 deficiency is pernicious anaemia. It is characterized by a triad of symptoms:Megaloblastic anaemiaGastrointestinal symptoms &Neurological symptoms

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      6.8
      Seconds

  • Question 24 - Which vaso metabolite decreases coronary blood flow? ...

    Incorrect

    • Which vaso metabolite decreases coronary blood flow?

      Your Answer: Prostaglandins

      Correct Answer: Endothelin

      Explanation:

      Decreased O2, increased CO2, lactate, prostaglandins, adenine nucleotides, adenosine, H+, K+ and cyanide produce vasodilation and thus an increase in coronary blood flow.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      27.7
      Seconds

  • Question 25 - Which of the following stimulate the release of aldosterone from the adrenal cortex?...

    Incorrect

    • Which of the following stimulate the release of aldosterone from the adrenal cortex?

      Your Answer: Hypokalaemia

      Correct Answer: Angiotensin 2

      Explanation:

      Angiotensin II also stimulates the secretion of the hormone aldosterone from the adrenal cortex. Aldosterone causes the renal tubules to increase the reabsorption of sodium and water into the blood, while at the same time causing the excretion of potassium (to maintain electrolyte balance).

    • This question is part of the following fields:

      • Medicine
      • Renal
      16.7
      Seconds

  • Question 26 - What is the principle site of action of adrenocorticotrophic hormone (ACTH)? ...

    Correct

    • What is the principle site of action of adrenocorticotrophic hormone (ACTH)?

      Your Answer: Adrenal gland

      Explanation:

      Adrenocorticotropic hormone, also known as ACTH or corticotropin, is a polypeptide tropic hormone. It is synthesized by the corticotropic cells of the anterior pituitary. It works by regulating the secretion of glucocorticoid hormones from the cortex cells in the adrenal gland. It binds to the melanocortin (MC) 2 receptors on the surface of the adrenal zona glomerulosa cells, producing cortisol.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      10.7
      Seconds

  • Question 27 - A 49 year old female presents to the clinic complaining of pain in...

    Incorrect

    • A 49 year old female presents to the clinic complaining of pain in her left elbow that is localized to the left lateral epicondyle. She has spent the weekend painting her house. A diagnosis of lateral epicondylitis is suspected. The pain would characteristically worsen on which of the following movements?

      Your Answer: Flexion of the elbow

      Correct Answer: Resisted wrist extension with the elbow extended

      Explanation:

      Lateral epicondylitis (tennis elbow) is an overuse injury of the hand and finger extensor tendons that originate in the lateral humeral epicondyle that occurs following repeated or excessive pronation/supination and extension of the wrist (e.g., in racquet sports). Clinical features include pain and tenderness over the lateral epicondyle and along extensor muscles, thickening of the tendons. The examiner holds the patient’s hand with the thumb placed over the lateral epicondyle – The patient makes a fist, supinates the forearm, deviates radially, and extends the fist against the examiner’s resistance which results in pain over the lateral epicondyle. Conservative treatment includes rest, physiotherapy and orthotic braces. If this fails corticosteroids and lidocaine injections are employed. Surgery is indicated in patients with persistent symptoms despite 6 months of conservative treatment. Excision of abnormal tendon tissue; longitudinal incisions (tenotomies) in scarred and fibrotic areas to promote healing.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      39.9
      Seconds

  • Question 28 - Regarding transportation of iron in the body, the process in which iron is...

    Incorrect

    • Regarding transportation of iron in the body, the process in which iron is transported from the enterocyte into the blood occurs using which transporter protein:

      Your Answer: Transferrin

      Correct Answer: Ferroportin

      Explanation:

      Divalent metal transporter 1 (DMT1) transport several divalent metals including iron across the enterocyte’s cell membrane into the cell. The cell can then release it into the body via the only known iron exporter in mammals, ferroportin.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      19.3
      Seconds

  • Question 29 - 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: Duke

      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
      15.5
      Seconds

  • Question 30 - 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: Activates complement

      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
      16.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Dermatology (1/2) 50%
Medicine (7/30) 23%
Endocrinology (1/4) 25%
Neurology (0/3) 0%
Pharmacology (0/2) 0%
Connective Tissue (0/2) 0%
Genetics (1/4) 25%
Cardiovascular (3/5) 60%
Respiratory (1/1) 100%
Renal (0/2) 0%
Haematology (0/3) 0%
Metabolism (0/1) 0%
Immunology (0/1) 0%
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