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Question 1
Correct
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Which cell type functions as the critical bridge between innate and adaptive immune systems, by activating naïve T lymphocytes?
Your Answer: Dendritic cells
Explanation:Dendritic cells are antigen presenting cells. They express class II MHC and T cell co-stimulatory molecules. They bind antigens and present them to native T cells and in the process activate the specific T cell against that antigen.
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This question is part of the following fields:
- Immunology
- Physiology
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Question 2
Correct
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The principal enzyme of lipid digestion is:
Your Answer: Lipase
Explanation:Lipase is the principle enzyme that digest lipids. Amylase digest carbohydrates. Colipase is a co-enzyme that optimize the activity of lipase. Trypsin digest proteins and cholesterol esterase digest cholesterol.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 3
Incorrect
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What is troponin?
Your Answer: A myosin heavy chain
Correct Answer: A component of thin filaments
Explanation:Skeletal muscle cytoplasmic proteins include myosin and actin (also known as thick and thin filaments, respectively) which are arranged in a repeating unit called a sarcomere. Troponin is a component of thin filaments (along with tropomyosin), and is the protein to which calcium binds.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 4
Incorrect
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A man suffers damage to his vagus nerve during surgery on his neck. The vagus nerve is cut near its exit from the skull. The man loses his parasympathetic tone raising his heart rate and blood pressure. What other feature will be likely present with a vagus nerve injury?
Your Answer: Pupillary constriction
Correct Answer: Hoarse voice
Explanation:The vagus nerve is a mixed nerve with both autonomic and somatic effects. Its most important somatic effect is the motor supply to the larynx via recurrent laryngeal nerves. If one vagus nerve is damaged, the result will be the same as damage to a single recurrent laryngeal nerve, leading to hoarseness of voice. The vagus exits the skull via the jugular foramen, accompanied by the accessory nerve. Anal tone, erections, and urination are all controlled by the sacral parasympathetic and would not be affected by the loss of the vagus. Parasympathetic controlled pupillary constriction is via the oculomotor nerve and would not be affected by the loss of the vagus.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 5
Correct
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Which of the following muscles is NOT involved in depression of the mandible:
Your Answer: Masseter
Explanation:Depression of the mandible is generated by the digastric, geniohyoid, mylohyoid and lateral pterygoid muscles on both side, assisted by gravity. The lateral pterygoid muscles are also involved as this movement also involves protraction of the mandible. The masseter muscle is a powerful elevator of the mandible.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 6
Incorrect
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Which of the following statements is correct with regards to Horner's syndrome?
Your Answer: Horner's syndrome results from damage to the oculomotor nerve.
Correct Answer: Miosis occurs due to paralysis of the dilator pupillae muscle.
Explanation:The characteristics of Horner’s syndrome are pupil constriction, partial ptosis and anhidrosis.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 7
Incorrect
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A 67-year-old man with chronic breathlessness is sent for a lung function test. Which statement concerning lung function testing is true?
Your Answer: Spirometry is a good predictor of quality of life in COPD
Correct Answer: In restrictive lung disease, the FEV 1 /FVC ratio is usually >0.7
Explanation:In restrictive lung disease, the FEV1/FVC ratio is usually >0.7%. In obstructive lung disease, FEV1 is reduced to <80% of normal and FVC is usually reduced. The FEV1/FVC ratio is reduced to 80% in the presence of symptoms Moderate airflow obstruction = FEV 1 of 50-79% Severe airflow obstruction = FEV 1 of 30-49% Very severe airflow obstruction = FEV1<30%. Spirometry is a poor predictor of quality of life in COPD. However, it can be used as part of the assessment of severity of COPD.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 8
Incorrect
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The following determines the strength of contraction
Your Answer: Depolarization
Correct Answer: Plateau phase
Explanation:The plateau phase which follows is unique to myocytes and results from a small, but sustained inward calcium current through L-type calcium channels lasting 200-400 ms. This calcium influx is caused by a combined increase in permeability of the cell and especially the sarcolemmal membranes to calcium. This plateau (or refractory) phase in myocyte action potential prevents early reactivation of the myocytes and directly determines the strength of contraction
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 9
Incorrect
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What is a characteristic findings on ECG in hyperkalaemia?
Your Answer: Shortened QT interval
Correct Answer: Tall, tented T waves
Explanation:Hyperkalaemia leads to:- Prolonged PR interval- Small P waves- Tall, tented T waves – Widened QRS complexes and eventually asystole.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 10
Incorrect
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Which statement describes endogenous transmission the best?
Your Answer: Transfer due to poor hygiene and contaminated food
Correct Answer: Commensal flora that gain access to an inappropriate area
Explanation:All answers A, B, C, and D are examples of exogenous infections. Endogenous infection is an infection by organisms that normally reside in the body but have previously been dormant.
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This question is part of the following fields:
- Infectious Diseases
- Physiology
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Question 11
Incorrect
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Within the hypothalamus, the dopamine-secreting neurones of the intrahypothalamic system have their cell bodies in which nuclei?
Your Answer: Paraventricular
Correct Answer: Arcuate
Explanation:Arcuate nucleus dopaminergic neurons consist of a single group of neurons that project to the median eminence where they release dopamine into the hypophyseal portal circulation to inhibit pituitary prolactin secretion.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 12
Incorrect
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In the jugular venous pressure wave…
Your Answer: ‘v’ wave coincide with rapid ventricular filling phase
Correct Answer: Consists of 3 peaks and 2 troughs
Explanation:The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system via visualization of the internal jugular vein. It can be useful in the differentiation of different forms of heart and lung disease. Classically three upward deflections (peaks) and two downward deflections (troughs) have been described:The upward deflections are the a (atrial contraction), c (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumetric systole) and v = venous filling.The downward deflections of the wave are the x (the atrium relaxes and the tricuspid valve moves downward) and the y descent (filling of ventricle after tricuspid opening).
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 13
Incorrect
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Which statement is correct about the clinical state of methemoglobinemia?
Your Answer: It is due to carbon monoxide reacting with haemoglobin.
Correct Answer: May arise due to a hereditary deficiency of NADH.
Explanation:Methaemoglobin is a form of haemoglobin that contains ferric [Fe3+] iron and has a decreased ability to bind oxygen. Spontaneously formed methaemoglobin is normally reduced by protective enzyme systems, e.g., NADH methaemoglobin reductase, hence a deficiency of NADH may result in increased levels of methaemoglobin
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This question is part of the following fields:
- Haematology
- Physiology
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Question 14
Incorrect
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What is the function of migrating motor complex
Your Answer: Stimulate peristalsis following ingestion of food
Correct Answer: Clears the gut of luminal contents in preparation of the next meal
Explanation:Migrating motor complexes (MMC) are waves of electrical activity that sweep through the intestines in a regular cycle during fasting. These motor complexes trigger peristaltic waves, which facilitate transportation of indigestible substances such as bone, fiber, and foreign bodies from the stomach, through the small intestine, past the ileocecal sphincter, and into the colon. The MMC occurs every 90–120 minutes during the interdigestive phase (between meals), and is responsible for the rumbling experienced when hungry. It also serves to transport bacteria from the small intestine to the large intestine, and to inhibit the migration of colonic bacteria into the terminal ileum.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 15
Correct
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Iron absorption occurs primarily in which part of the GIT?
Your Answer: Duodenum
Explanation:Like most mineral nutrients, the majority of the iron absorbed from digested food or supplements is absorbed in the duodenum by enterocytes of the duodenal lining.
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This question is part of the following fields:
- Haematology
- Physiology
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Question 16
Incorrect
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The interventricular septum is supplied anteriorly by the?
Your Answer: Circumflex artery
Correct Answer: Left anterior descending artery
Explanation:The anterior interventricular artery or left anterior descending artery supplies the anterior 2/3rds of the interventricular septum.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 17
Incorrect
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Antibiotic resistance may happen by:
Your Answer: None of the above
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.
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This question is part of the following fields:
- Infectious Diseases
- Physiology
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Question 18
Correct
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A 58-year-old patient presents with sputum production and worsening exertional breathlessness. A spirometry is done and his results leads to a diagnosis of obstructive lung disease with mild airflow obstruction. What FEV1 value would correspond with mild airflow obstruction according to the NICE guidelines?
Your Answer: FEV 1 >80%
Explanation:Airflow obstruction according to the latest NICE guidelines, is defined as: Mild airflow obstruction = an FEV 1 of >80% in the presence of symptoms Moderate airflow obstruction = FEV 1 of 50-79% Severe airflow obstruction = FEV 1 of 30-49% Very severe airflow obstruction = FEV1<30%.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 19
Correct
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Which of the following is untrue about mitochondrial chromosome disorders?
Your Answer: Because mitochondrial chromosomes have no introns in their genes, any point mutation has a low likelihood of having an effect.
Explanation:All are true except for B. Any point mutation in any part of the mitochondrial DNA will lead to a mutated mitochondria and will likewise have its ill effect on the body.
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This question is part of the following fields:
- Genetics
- Physiology
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Question 20
Correct
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Regarding gustatory sensation:
Your 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.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 21
Incorrect
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Which of the following has the shortest duration:
Your Answer: PR interval
Correct Answer: Atrial systole: 0.1s
Explanation:Atrial systole: 0.1sAtrial diastole: around 0.4sVentricular diastole: 0.4-0.53s.Ventricular systole: 0.27sPR interval: 0.12-0.2 s
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 22
Incorrect
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The end product of trehalase action on oligosaccharides is
Your Answer: A molecule of glucose and a molecule of fructose
Correct Answer: Two glucose molecules
Explanation:Disaccharides are glycoside hydrolases, enzymes that break down certain types of sugars called disaccharides into simpler sugars called monosaccharides.Examples of disaccharides:Lactase (breaks down lactose into glucose and galactose)Maltase (breaks down maltose into 2 glucoses)Sucrase (breaks down sucrose into glucose and fructose)Trehalase (breaks down trehalose into 2 glucoses)
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 23
Correct
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Select the correct statement regarding the macro anatomy of the thyroid gland.
Your Answer: It surrounds the trachea at the front of the neck.
Explanation:The thyroid is located around the trachea, in the anterior portion of the neck. It is formed by two lobes which are connected by an isthmus. The presence of a pyramidal lobe, or third lobe, is considered to be a normal anatomical variant. It originates from the primitive pharynx and the neural crest and has a rich vascular supply.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 24
Incorrect
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The 'pump handle' movement of the thoracic wall describes which of the following movements:
Your Answer: The middles of the shafts of the ribs moving upwards and laterally
Correct Answer: The anterior ends of the ribs moving upwards and forwards
Explanation:Because the anterior ends of the ribs are inferior to the posterior ends, when the ribs are elevated, the anterior end moves upwards and forwards, moving the sternum upwards and forwards in turn. This ‘pump handle’ upwards and forwards movement changes the anteroposterior (AP) dimension of the thorax.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 25
Incorrect
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Of the following, which is NOT a branch of the abdominal aorta?
Your Answer: Renal artery
Correct Answer: Superior phrenic artery
Explanation:The abdominal aorta begins at the level of the body of T12 near the midline, as a continuation of the thoracic aorta. It descends and bifurcates at the level of L4 into the common iliac arteries. The branches of the abdominal aorta (with their vertebra level) are: 1. Inferior phrenic arteries: T12 (upper border) 2. Coeliac artery: T12 3. Superior mesenteric artery: L1 4. Middle suprarenal arteries: L1 5. Renal arteries: Between L1 and L2 6. Gonadal arteries: L2 (in males, it is the testicular artery, and in females, the ovarian artery) 7. Inferior mesenteric artery: L3 8. Median sacral artery: L4 9. Lumbar arteries: Between L1 and L4 The superior phrenic artery branches from the thoracic aorta.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 26
Incorrect
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Hydroxyl radicals are broken down by which of the following substance?
Your Answer: Hydroxyl reductase
Correct Answer: Antioxidants
Explanation:Unlike superoxide, which can be detoxified by superoxide dismutase, the hydroxyl radical cannot be eliminated by an enzymatic reaction but it is believed can be counteracted by antioxidants.
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This question is part of the following fields:
- Cell Biology
- Physiology
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Question 27
Incorrect
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Question 28
Incorrect
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What is the mostly likely cause of prolonged activated partial thromboplastin time (aPPT) ?
Your Answer: Malabsorption of vitamin K
Correct Answer: Heparin therapy
Explanation:The partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) is an indicator for measuring the efficacy of both the intrinsic and common coagulation pathway. Prolonged aPTT may indicate: use of heparin, antiphospholipid antibody and coagulation factor deficiency (e.g., haemophilia). Deficiencies of factors VIII, IX, XI and XII and rarely von Willebrand factor (if causing a low factor VIII level) may lead to a prolonged aPTT correcting on mixing studies.
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This question is part of the following fields:
- Haematology
- Physiology
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Question 29
Incorrect
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A 28-year-old woman with history of blunt thoracic trauma develops hypotension chest pain, and breathlessness. A bedside echocardiogram was performed and revealed a large pericardial effusion. Due to this finding, a pericardiocentesis was to be performed. Which of the following statements is considered true regarding pericardiocentesis?
Your Answer: The pericardial cavity usually contains around 200 ml of pericardial fluid
Correct Answer: The needle should be aimed at the midpoint of the left clavicle
Explanation:Pericardiocentesis is a procedure done to remove fluid build-up in the sac around the heart known as the pericardium. The pericardium can be tapped from almost any reasonable location on the chest wall. However, for the usual blind pericardiocentesis, the subxiphoid approach is preferred. Ideally, 2-D echocardiography is used to guide needle insertion and the subsequent path of the needle/catheter. In the subxiphoid approach, the needle is inserted 1 cm inferior to the left xiphocostal angle with an angle of 30 degrees from the patient’s chest with a direction towards the left mid-clavicle. The fingers may sense a distinct give when the needle penetrates the parietal pericardium. Successful removal of fluid confirms the needle’s position.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 30
Incorrect
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The blood supply to the greater curvature of the stomach is via the:
Your Answer: Right and left gastric arteries
Correct Answer: Right and left gastro-epiploic arteries
Explanation:The blood supply to the greater curvature of the stomach is via the left and the right gastro-epiploic arteries branching from the splenic artery near the hilum.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
