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Question 1
Correct
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The febrile response to PGE2 will be impaired with the knockout of which one of the following prostaglandin receptors?
Your Answer: Ep3
Explanation:Prostaglandin EP3 receptor is a receptor for prostaglandin E2. Fever occurs as a result of the action of prostaglandin E2 and requires EP3 receptors in the preoptic area. Therefore, if there is an absence of EP3 receptors, fever caused by prostaglandin E2 will not occur.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 2
Correct
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HCL is secreted by which cells in the stomach
Your Answer: Parietal cells
Explanation:Parietal cells are the epithelial cells that secrete hydrochloric acid (HCl) and intrinsic factor. These cells are located in the gastric glands found in the lining of the fundus and in the body of the stomach.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 3
Incorrect
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Functions of the glossopharyngeal nerve include the following except:
Your Answer: Transmission of afferent impulses from the carotid baro- and chemoreceptors to the nucleus tractus solitarius in the medulla
Correct Answer: Proprioceptive input from muscles of the tongue and larynx
Explanation:The glossopharyngeal nerve is a mixed nerve consisting of both sensory and motor fibers. It has several branches and five distinct general functions:Branchial motor- Special visceral efferent- supplies the Stylopharyngeus muscle and superior constrictor muscle.Visceral motor- general visceral efferent- provides parasympathetic innervation of the parotid gland.Visceral sensory- general visceral afferent- carries visceral sensory information from the carotid sinus and carotid body.General sensory- general somatic afferent- provides general sensory information from the inner surface of the tympanic membrane, upper pharynx and posterior one third of the tongue.Visceral afferent- special visceral afferent- provides taste sensation from the posterior one third of the tongue including the circumvallate papillae.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 4
Incorrect
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Regarding the anatomy of the intestine, the muscularis propria contains all of which of the following constituents?
Your Answer: Submucosa, muscularis mucosa, mesothelium
Correct Answer: Circular muscle, myenteric plexus, longitudinal muscle
Explanation:The muscularis mucosa/propria consists of the inner circular muscles and the outer longitudinal muscles. Between these muscles is the myenteric plexus.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 5
Correct
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Question 6
Correct
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A 51-year-old real estate agent takes hydrocortisone 20mg in the mornings and 5mg at night for Addison’s disease. The endocrinology consultant would like her to take prednisolone instead. What dose of prednisolone should be started?
Your Answer: 7 mg
Explanation:1mg Prednisolone = 4mg hydrocortisone, so the actual equivalent daily dose is 7mg.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 7
Incorrect
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Which one of the following makes up most of the adrenal cortex?
Your Answer: Zona glomerulosa
Correct Answer: Zona fasciculata
Explanation:The zona fasciculata represents the widest area of the adrenal cortex, situated in the middle of the cortex. It produces glucocorticoids including; 11-deoxycorticosterone, corticosterone, and cortisol.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 8
Incorrect
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Defects in chromosomal structure (and examples) include those mentioned below except:
Your Answer: Duplication (Charcot-Marie-tooth syndrome; duplication of a region of chromosome 17)
Correct Answer: Lyonization (x-linked disorders)
Explanation:All are true except for A) Lyonization which is the inactivation of the X chromosomes in a female. It is not a chromosomal abnormality.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 9
Incorrect
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ADH causes?
Your Answer: Upregulates aquaporin 1
Correct 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 10
Correct
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Which of the following biochemical profiles is seen in a normal 65 year old female? (in comparison to a normal 24 yr. old female)
Your Answer: Increased FSH, LH; decreased oestrogen, progesterone
Explanation:During menopause, a woman’s number of ovarian follicles becomes depleted; as a result, oestrogen and progesterone levels drop, and LH and FSH levels increase. One of the criteria to diagnose menopause is the absence of menstrual period for a year, along with a serum FSH level increased to 30 mIU/ml or higher. LH also rises with the onset of menopause.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 11
Incorrect
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Which of the following causes the closure of the ductus arteriosus during birth?
Your Answer: Reduction of pulmonary vascular resistance
Correct Answer: Reduced levels of prostaglandins
Explanation:Ductus arteriosus is kept open by the prostaglandin E2 which is a vasodilator. At birth the high levels of cyclooxygenase blocks the production of prostaglandins which results in the closure of the ductus arteriosus.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 12
Correct
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The onset of puberty is triggered by
Your Answer: Increase in pulsatile GNRH secretion from hypothalamus
Explanation:The onset of puberty is associated with high GNRH pulsing, which precedes the rise in sex hormones. Brain tumours which increase GNRH output may also lead to premature puberty. The cause of the GNRH rise is unknown.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 13
Correct
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Which of the following happens when anterograde neurons are stimulated?
Your Answer: Smooth muscle relaxation ahead of the stimulus
Explanation:Nitric oxide is thought to act as an anterograde neurotransmitter. Nitric oxide causes relaxation of smooth muscles ahead of the stimulus. Clinically it is used as a potent vasodilator.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 14
Correct
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A 71-year-old woman residing in a nursing home for a couple of years complains of drooling of saliva and sudden difficulty in swallowing while eating. She is a known hypertensive on treatment. What would be your next step?
Your Answer: Endoscopy
Explanation:Dysphagia or difficulty in swallowing. Endoscopy allows for visual examination of the oesophagus and is indicated in patients with dysphagia to determine the underlying aetiology, exclude malignant and premalignant conditions, assess the need for therapy, and perform therapy including dilation.
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This question is part of the following fields:
- Geriatrics
- Medicine
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Question 15
Incorrect
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A 34 year old woman presents to the emergency department due to right sided weakness. Past history reveals a DVT following the birth of her daughter, and two miscarriages. Head CT confirms an ischaemic stroke in the territory of left middle cerebral artery. What would be the most likely finding on echocardiography?
Your Answer: Atrial septal defect
Correct Answer: Normal
Explanation:The patient most likely suffers from antiphospholipid syndrome. The clinical criteria consist of vascular thrombosis and pregnancy morbidity. Vascular thrombosis is defined as one or more clinical episodes of arterial, venous, or small-vessel thrombosis in any tissue or organ confirmed by findings from imaging studies, Doppler studies, or histopathology. ASD, VSDs would cause paradoxical emboli and stroke, however the recurrent pregnancy loss in this case is strongly suggestive of antiphospholipid syndrome. The ECG would be normal in most cases associated with anti phospholipid syndrome.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 16
Correct
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Amongst the following cells, which is responsible for the secretion of defensins?
Your Answer: Neutrophils
Explanation:Eosinophils are phagocytic and they are directed against helminths. Basophils are involved in allergic reactions and contain histamine and vasoactive granules in their cytoplasm. Mast cells are similar to basophils. Monocytes differentiate into macrophages in the tissue, secret interleukins and are phagocytic. Neutrophils are phagocytic but are also responsible for secreting defensins.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 17
Incorrect
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Which of the following conditions results from chromosomal ‘non-disjunction’?
Your Answer: Down syndrome
Correct Answer: All of the options
Explanation:Non-disjunction can result in aneuploidy i.e. abnormal number of chromosomes in a cell. It results due to uneven division of chromosomes in the meiosis 1 or 2 phase. All the above mentioned examples are of non-disjunction.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 18
Correct
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A 22 year old nulliparous female presents with shortness of breath. She has a history of recurrent deep vein thrombosis. Complete blood count and clotting screen reveals the following results:Hb: 12.4 g/dl Plt: 137 WBC: 7.5*109/l PT: 14 secs APTT: 46 secs Which of the following would be the most likely diagnosis?
Your Answer: Antiphospholipid syndrome
Explanation:The combination of APTT and low platelets with recurrent DVTs make antiphospholipid syndrome the most likely diagnosis.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 19
Incorrect
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A 42-year-old female with type 1 diabetes who has undergone a renal transplant is being reviewed. She is taking azathioprine and tacrolimus for immunosuppression.Which among the following is correct regarding the given immunosuppressive agents?
Your Answer: Tacrolimus has a half-life of around 5 hours
Correct Answer: Tacrolimus is a calcineurin inhibitor
Explanation:Tacrolimus is a calcineurin inhibitor used as an immunosuppressive agent used for prophylaxis of organ rejection post-transplant.Pharmacology: Calcineurin inhibition leads to reduced T-lymphocyte signal transduction and IL-2 expression. It has a half-life of 12 hours (average).Other off-label indications for the use of tacrolimus include Crohn disease, graft-versus-host disease (GVHD), myasthenia gravis, rheumatoid arthritis.Adverse effects of tacrolimus includes: Cardiovascular: Angina pectoris, cardiac arrhythmias, hypertensionCentral nervous system: Abnormal dreams, headaches, insomnia, tremors.Dermatologic: Acne vulgaris, alopecia, pruritis, rashEndocrine and metabolic: Decreased serum bicarbonate, decreased serum iron, new-onset diabetes mellitus after transplant (NODAT), electrolyte disturbances.Gastrointestinal: Abdominal pain, nausea, vomiting, diarrhoeaGenitourinary: Urinary tract infectionHepatic: Abnormal hepatic function testsNeuromuscular and skeletal: Arthralgia, muscle crampsOphthalmic: Blurred vision, visual disturbanceOtic: Otalgia, otitis media, tinnitusRenal: Acute renal failureOther options:Sirolimus (a macrolide) is an mTOR inhibitor that blocks the response to IL-2 and has a half-life of 12–15 hours. Azathioprine inhibits purine synthesis, an essential step in the proliferation of white cells and has a half-life of around 5 hours.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 20
Incorrect
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Which of the following are true when it comes to tumour suppressor genes:
Your Answer: Mutation in the Rb gene leads to retinoblastoma
Correct Answer: All of the options are true
Explanation:All of the above mentioned statements are true regarding tumour suppressor genes. Tumour suppressor genes generally follow the two-hit hypothesis, which implies that both alleles that code for a particular protein must be affected before an effect is manifested.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 21
Correct
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Visual pathways - Choose the true statement:
Your Answer: The lateral geniculate nucleus, magnocellular & parvocellular pathways project to the primary visual cortex
Explanation:The optic chiasm is made by the decussation of optic fibers on the nasal side. The magnocellular pathway carries signals for detection of movement. The parvocellular pathway carries cells for detection of shape, size, colour and clarity. The lateral geniculate nucleus (LGN) is the relay centre in the thalamus for he visual pathway. It has layers of magnocellular cells and parvocellular cells that are interleaved with layers of koniocellular cells. The LGN is the main central connection for the optic nerve to the occipital lobe, particularly the primary visual cortex.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 22
Correct
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A 42 year old male arrives at the clinic due to cough and haemoptysis. Examination shows nasal mucosal ulceration. The doctor suspects Wegener's granulomatosis. Which anatomical area would be most commonly involved in this condition?
Your Answer: Lungs
Explanation:Granulomatosis with polyangiitis (GPA, previously known as Wegener’s granulomatosis) is a systemic vasculitis that affects both small and medium-sized vessels. Patients typically initially suffer from a limited form that may consist of constitutional symptoms and localized manifestations such as chronic sinusitis, rhinitis, otitis media, ocular conditions. In later stages, more serious manifestations may arise, including pulmonary complications and glomerulonephritis, although the skin, eyes, and heart may also be involved but these lesions are less common. Diagnosis is based on laboratory testing (positive for PR3-ANCA/c-ANCA), imaging, and biopsy of affected organs, which demonstrate necrotizing granulomatous inflammation. GPA is treated with immunosuppressive drugs, typically consisting of glucocorticoids combined with methotrexate, cyclophosphamide, or rituximab. Relapses are common and the following systems are affected: Lower respiratory tract (95% of cases), renal involvement (80% of cases), skin lesions (45% of cases), ocular involvement (45% of cases) and cardiac involvement (33% of cases).
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 23
Correct
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The following are Gram positive rods:
Your Answer: Clostridia
Explanation:Examples of Gram positive bacilli:Bacillus genusClostridium genusCorynebacterium genusListeria genusPropionibacterium genusExamples of Gram negative bacilli:Bacteroides genusCitrobacter genusEnterobacter genusEscherichia genusPseudomonas genusProteus genusSalmonella genusSerratia genusShigella genusYersinia genus
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 24
Incorrect
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Which of the following best describe Clostridium infection?
Your Answer: Gram positive cocci
Correct Answer: Anaerobe
Explanation:Clostridium is a genus of Gram-positive bacteria, which includes several significant human pathogens, including the causative agent of botulism and an important cause of diarrhoea, Clostridium difficile. They are obligate anaerobes capable of producing endospores. The normal, reproducing cells of Clostridium, called the vegetative form, are rod-shaped, which gives them their name, from the Greek κλωστήρ or spindle.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 25
Correct
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Question 26
Incorrect
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Organophosphates, such as Sarin, have been used as chemical-warfare agents by terrorists. Which of the following statements is true concerning organophosphate poisoning?
Your Answer: Organophosphate neuropathy occurs within 24 hours
Correct Answer: Atropine is useful in the management of organophosphate poisoning
Explanation:The principal action of organophosphates is the inhibition of acetylcholinesterase’s, therefore leading to the accumulation of acetylcholine at muscarinic receptors (miosis, hypersalivation, sweating, diarrhoea, excessive bronchial secretions), nicotinic receptors (muscle fasciculations and tremor) and in the central nervous system (anxiety, loss of memory, headache, coma). Removal from the source of the organophosphate, adequate decontamination, supplemental oxygen and atropine are the initial treatment measures. Pralidoxime, an activator of cholinesterase, should be given to all symptomatic patients.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 27
Incorrect
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Into how many functional units can the cerebellum be divided?
Your Answer: 2
Correct Answer: 3
Explanation:The functional division of the cerebellum are the: Vestibulocerebellum (floculonodular lobe), Spinocerebellum (vermis and associated areas in the midline) and cerebrocerebellum (lateral hemispheres).
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This question is part of the following fields:
- Medicine
- Neurology
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Question 28
Incorrect
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Question 29
Correct
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With regards to environmental temperature, for each degree Celsius of elevation, the metabolic rate rises?
Your Answer: 0.14
Explanation:An increase in body temperature is associated with a higher metabolic rate. Evidence suggests that an increase of 1°C in your body temperature increases your metabolism by 10 to 14%.
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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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According to the Vaughan William's classification of antiarrhythmic agents, lidocaine is a:
Your Answer:
Correct Answer: Class Ib agent
Explanation:Lidocaine is an example of class IB antiarrhythmics.The Vaughan-Williams classification of antiarrhythmicsI: Membrane stabilizing agentsIA: Quinidine, Procainamide, DisopyramideIB: Lidocaine, MexiletineIC: Propafenone, Flecainide II: β blockers – Propranolol, EsmololIII: Agents widening AP – Amiodarone, Dronedarone, Dofetilide, Ibutilide, SotalolIV: Calcium channel blockers – Verapamil, DiltiazemV: Miscellaneous – Digoxin, adenosine, magnesium
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This question is part of the following fields:
- Medicine
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
