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Question 1
Incorrect
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Which is the primary lymphoid organ?
Your Answer: Spleen
Correct Answer: Thymus
Explanation:Lymphoid organs consist of lymph nodes, the thymus, spleen and tonsils. The thymus is the primary lymphoid organ as it is the organ in which the T cells mature.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 2
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 3
Incorrect
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Antibiotic resistance may happen by:
Your Answer: By active expulsion of drug by nuclear efflux systems
Correct Answer: By enzymes which inactivate the drug
Explanation:The three main mechanisms of antibiotic resistance are, enzymatic degradation of antibacterial drugs, alteration of bacterial proteins that are antimicrobial targets, and changes in membrane permeability to antibiotics.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 4
Incorrect
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Which of the following is NOT a pancreatic enzyme?
Your Answer: Colipase
Correct Answer: Pepsinogen 1
Explanation:Pancreatic juice, composed of the secretions of both ductal and acinar cells, is made up of the following digestive enzymes:Trypsinogen, which is an inactive(zymogenic) protease that, once activated in the duodenum into trypsin, breaks down proteins at the basic amino acids. Trypsinogen is activated via the duodenal enzyme enterokinase into its active form trypsin.Colipase is a protein co-enzyme required for optimal enzyme activity of pancreatic lipase. It is secreted by the pancreas in an inactive form, procolipase, which is activated in the intestinal lumen by trypsin.Chymotrypsinogen, which is an inactive (zymogenic) protease that, once activated by duodenal enterokinase, breaks down proteins at their aromatic amino acids. Chymotrypsinogen can also be activated by trypsin.Carboxypeptidase, which is a protease that takes off the terminal amino acid group from a proteinSeveral elastases that degrade the protein elastin and some other proteins.Pancreatic lipase that degrades triglycerides into fatty acids and glycerol.Sterol esterasePhospholipaseSeveral nucleases that degrade nucleic acids, like DNase and RNase.Pancreatic amylase that breaks down starch and glycogen which are alpha-linked glucose polymers.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 5
Incorrect
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Which one of the following nerve fibers is involved in proprioception?
Your Answer: A γ fiber
Correct Answer: An α fiber
Explanation:Proprioception, also known as kinaesthesia, is the sense through which humans perceive their own position and movements. α nerve fibers are specifically involved in transmitting proprioception stimuli.
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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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Oxidation is defined as a:
Your Answer: Loss of oxygen from substances
Correct Answer: Loss of electrons from molecules
Explanation:Oxidation is the loss of electrons or an increase in oxidation state by a molecule, atom, or ion.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 7
Incorrect
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Cholecystokinin causes the pancreas to
Your Answer: Secrete large amounts of acidic pancreatic juice
Correct Answer: Produce pancreatic juice rich in enzymes
Explanation:Cholecystokinin (CCK) mediates digestion in the small intestine by inhibiting gastric emptying and decreasing gastric acid secretion. It stimulates the acinar cells of the pancreas to release a juice rich in pancreatic digestive enzymes, hence the old name pancreozymin. Together these enzymes catalyse the digestion of fat, protein, and carbohydrates.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 8
Correct
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Normal parents have a child with a recessive condition, Tay Sachs. The chance of them having a normal child is?
Your 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%.
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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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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, decreased LH; decreased oestrogen, progesterone
Correct 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 10
Incorrect
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The a-wave is created by:
Your Answer: Rise in atrial pressure before the tricuspid valve opens
Correct Answer: Regurgitation of some blood to the great veins when the atria contracts in atrial systole
Explanation:The a-wave created on the venous pulse curve occurs as a result of atrial systole. Due to the pressure build-up in the atria, it causes a back pressure in the vena cava. This pressure is exerted on the valve and this back pressure is what causes a slight increase in the venous pressure.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 11
Correct
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Which part of the neuron has the highest concentration of sodium channels per square millimetre of the cell membrane?
Your Answer: Nodes of Ranvier
Explanation:The nodes of Ranvier contain Na+/K+ ATPases, Na+/Ca2+ exchangers and a high density of Na+ channels. The estimated concentration of sodium channels in the node is of ∼1500/μm2.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 12
Correct
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A 78 year old woman presents to the clinic complaining of left sided temporal headaches and jaw claudication that has been going on for a month. A left temporal artery biopsy is negative. Results show:Hb: 130g/lPlatelets: 359*109/lWBC: 10*109/lCRP: 89mg/lWhich of the following options would be the next best step in the management of this patient?
Your Answer: Commence prednisolone
Explanation:Temporal arteritis is a chronic large- and medium-sized vessel vasculitis that typically involves the temporal arteries. Classical symptoms include temporal headaches, jaw claudication, amaurosis fugax. Physical exam shows scalp tenderness, palpation of the temporal area may demonstrate an absent pulse, knot-like swelling and vision loss. Lab results reveal an increased erythematous sedimentation rate and C-reactive protein. Temporal artery biopsy confirms the diagnosis. Management approach: high-dose systemic corticosteroids should be promptly administered even before the diagnosis is established. Temporal artery biopsy confirms the diagnosis. Inability to manage this or administer glucocorticoids might lead to development of blindness.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 13
Correct
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Question 14
Incorrect
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Which of the following is true with AV nodal delay?
Your Answer: The delay is about 0.01s
Correct Answer: Shortened by sympathetic stimulation
Explanation:AV nodal delay Is about 0.1s before the action potential spreads to the ventricles. It is shortened by stimulation of the sympathetic nervous system and lengthened by stimulation of the parasympathetic system.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 15
Correct
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Approximately what percentage of the world is infected with tuberculosis:
Your Answer: 25%
Explanation:The WHO report states that about one-quarter of the world’s population is infected with Mycobacterium tuberculosis, the bacterium that causes tuberculosis. This means approximately 25% of people globally have latent TB infection, which can potentially progress to active TB disease.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 16
Incorrect
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Anti-gastroesophageal reflux mechanisms include the following except:
Your Answer: The phrenoesophageal ligament
Correct Answer: Peristaltic movements of the oesophagus
Explanation:The lower oesophageal sphincter contracts preventing reflux of acid into the oesophagus. The sling muscles of the stomach, the crura of the diaphragm and the phreno-oesophageal ligament all play an important role in constricting the lower portion of the oesophagus and preventing reflux. Peristaltic movements do not stop the acid reflux.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 17
Correct
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Which enzyme is deficient in the inborn error of metabolism called galactosemia?
Your Answer: Galactose-1-phosphate uridyl transferase
Explanation:Galactosaemia is a rare genetic autosomal recessive metabolic disorder. Lactose is broken down by the enzyme lactase into glucose and galactose. In individuals with galactosemia, the enzymes needed for further metabolism of galactose (Galactose-1-phosphate uridyltransferase) are severely diminished or missing entirely, leading to toxic levels of galactose 1-phosphate in various tissues.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 18
Incorrect
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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: Digoxin
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.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 19
Correct
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The choroid plexus:
Your Answer: All are true
Explanation:The choroid plexus is a vascular structure found in all cerebral ventricles. The functional unit of the choroid plexus, composed of a capillary, enveloped by a layer of differentiated ependymal epithelium. Unlike the capillaries that form the blood-brain barrier, choroid plexus capillaries are fenestrated and have no tight junctions. The endothelium, therefore, does not form a barrier to the movement of small molecules. Instead, the blood-CSF barrier at the choroid plexus is formed by the epithelial cells and the tight junctions that link them.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 20
Correct
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The process by which DNA fragments are separated by gel and transferred onto a membrane sheet is called:
Your Answer: Southern blotting
Explanation:A Southern blot is a method used in molecular biology for detection of a specific DNA sequence in DNA samples. Southern blotting combines transfer of electrophoresis-separated DNA fragments to a filter membrane and subsequent fragment detection by probe hybridization. The other forms of blotting involve the use of RNA and proteins.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 21
Incorrect
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Which hormone is associated with the temperature surge in hot flushes?
Your Answer: Oestrogen
Correct Answer: LH
Explanation:Luteinizing hormone or LH is a hormone produced by the anterior pituitary gland. Studies have shown surges in LH levels during menopausal hot flushes, suggesting that a pulsatile release of LH is responsible for increased hypothalamic norepinephrine activity, causing the hot flushes.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 22
Correct
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Which of the following is matched correctly with regard to stem cells of the bone marrow?
Your Answer: Hemopoietic stem cells - basophils
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 give rise to both the myeloid and lymphoid lineages of blood cells. (Myeloid cells include monocytes, macrophages, neutrophils, basophils, eosinophils, erythrocytes, dendritic cells, and megakaryocytes or platelets. Lymphoid cells include T cells, B cells, and natural killer cells.)
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This question is part of the following fields:
- Haematology
- Medicine
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Question 23
Correct
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Where is the majority of Mg2+ absorbed?
Your Answer: Thick ascending limb of loop of Henle.
Explanation:Although the majority of the filtered magnesium is reabsorbed within the ascending loop of Henle, it is now recognized that the distal tubule also plays an important role in magnesium conservation.
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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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Arachidonic acid is converted to:
Your Answer: Cyclooxygenase
Correct Answer: Prostaglandin H2
Explanation:The enzymes cyclooxygenase-1 and -2 (i.e. prostaglandin G/H synthase 1 and 2 {PTGS1 and PTGS2}) metabolize arachidonic acid to Prostaglandin G2 and prostaglandin H2.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 25
Correct
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The production of bile is increased by: Stimulation of the ____ nerve and the hormone ____.
Your Answer: Vagus, CCK
Explanation:Cholecystokinin is synthesized and secreted by enteroendocrine cells in the duodenum, the first segment of the small intestine, and causes the release of digestive enzymes and bile from the pancreas and gallbladder, respectively. It also acts as a hunger suppressant. Release of CCK is stimulated by monitor peptide released by pancreatic acinar cells as well as CCK-releasing protein, a paracrine factor secreted by enterocytes in the gastrointestinal mucosa. In addition, release of acetylcholine by the parasympathetic nerve fibers of the vagus nerve also stimulate its secretion.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 26
Incorrect
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The transport of the di- and tri-peptides into enterocytes is by:
Your Answer: Cl- dependent peptide transporter 2
Correct Answer: H+ dependent peptide transporter 1
Explanation:Peptides longer that four amino acids are not absorbed. There is abundant absorption of di and tri peptidases in the small intestine. They are absorbed into the epithelial cell of the small intestine via a transporter called Peptide Transporter 1 by co transport with H+ ions.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 27
Correct
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A 28 year old female with a history of psoriatic arthritis would most likely have which of the following hand conditions?
Your Answer: Nail dystrophy
Explanation:Nail dystrophy (pitting of nails, onycholysis, subungual hyperkeratosis), dactylitis, sausage shaped fingers are most commonly seen with psoriatic arthropathy. There is asymmetric joint involvement most commonly distal interphalangeal joints. Uveitis and sacroiliitis may also occur. Arthritis mutilans may occur but is very rare. Cutaneous lesions may or may not develop. When they do, its usually much after the symptoms of arthritis.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 28
Correct
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In Hirschsprung disease which one is incorrect
Your Answer: Due to congenital absence of myenteric and submucosal plexuses
Explanation:During normal prenatal development, cells from the neural crest migrate into the large intestine (colon) to form the networks of nerves called the myenteric plexus (Auerbach plexus) (between the smooth muscle layers of the gastrointestinal tract wall) and the submucosal plexus (Meissner plexus) (within the submucosa of the gastrointestinal tract wall). In Hirschsprung’s disease, the migration is not complete and part of the colon lacks these nerve bodies that regulate the activity of the colon. The affected segment of the colon cannot relax and pass stool through the colon, creating an obstruction.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 29
Correct
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A 65-year-old man, after suffering from a pathological rib fracture, complains of recurrent infection. Bone marrow aspiration revealed a calcium level of 3.9 mmol/l and alkaline phosphatase level of 160u/l. What type of cell would be found in abundance in the marrow spear?
Your Answer: Plasma cells
Explanation:Multiple myeloma or plasma cell myeloma, is a cancer of plasma cells, responsible for producing antibodies. It often, presents early with no symptoms followed by bone pain and pathological fractures (metastases), raised calcium levels, bleeding, frequent infections, and anaemia. It usually occurs around the age of 61 and is more common in men than women.
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This question is part of the following fields:
- Geriatrics
- Medicine
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Question 30
Incorrect
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After eating a meal containing a moderate amount of fat, which percentage of fat is likely to be absorbed from the GIT in an adult?
Your Answer: 50%
Correct Answer: 95%
Explanation:About 95% of dietary fat is absorbed.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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