-
Question 1
Correct
-
An 82 year old male woke up experiencing incoherent speech - he is also finding it difficult to find the right words to explain his thoughts. Doctors have examined him, and everything else appears to be normal. They have also found that his comprehension is good. From the list of options, choose the anatomical site which in this instance, is most likely affected.
Your Answer: Broca’s Area
Explanation:The combination of good comprehension but poor speech quality in this patient is consistent with damage to the Broca’s area. The Wernicke’s area is responsible for the understanding of speech, and so is not consistent with this patient.
-
This question is part of the following fields:
- Geriatrics
- Medicine
-
-
Question 2
Correct
-
Vasodilatation in skeletal muscle can be caused by:
Your Answer: Sympathetic cholinergic nerves
Explanation:In skeletal muscles some fibers that cause vasodilation run with the nerves of the sympathetic system but are cholinergic in nature. These nerves are not active during rest but become active during exercise and stress.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 3
Incorrect
-
A 53-year-old female teacher asks about hormone replacement therapy (HRT). What is the most compelling indication for starting HRT?
Your Answer: Prevention of osteoporosis
Correct Answer: Control of vasomotor symptoms such as flushing
Explanation:Hormone replacement therapy (HRT) involves the use of a small dose of oestrogen, combined with a progestogen (in women with a uterus), to help alleviate menopausal symptoms. The main indication is the control of vasomotor symptoms. The other indications, such as reversal of vaginal atrophy and prevention of osteoporosis, should be treated with other agents as first-line therapies.
-
This question is part of the following fields:
- Medicine
- Pharmacology
-
-
Question 4
Incorrect
-
Which vitamin is found in NAD and NADP?
Your Answer: Vitamin B1
Correct Answer: Vitamin B3
Explanation:In organisms, NAD can be synthesized from simple building-blocks (de novo) from the amino acids tryptophan or aspartic acid. In an alternative fashion, more complex components of the coenzymes are taken up from food as the vitamin called niacin (vitamin B3)
-
This question is part of the following fields:
- Haematology
- Medicine
-
-
Question 5
Incorrect
-
The extrinsic coagulation pathway is initiated by activation of which clotting factor?
Your Answer: Factor II
Correct Answer: Factor VII
Explanation:The tissue factor pathway (extrinsic) begins following damage to the blood vessel. FVII leaves the circulation and comes into contact with tissue factor (TF) expressed on tissue-factor-bearing cells (stromal fibroblasts and leukocytes), forming an activated complex (TF-FVIIa).
-
This question is part of the following fields:
- Haematology
- Medicine
-
-
Question 6
Incorrect
-
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: 75%
Correct Answer: 95%
Explanation:About 95% of dietary fat is absorbed.
-
This question is part of the following fields:
- Gastrointestinal
- Medicine
-
-
Question 7
Incorrect
-
When during the cell cycle does DNA replication occur?
Your Answer: G1 phase
Correct Answer: S phase
Explanation:The S phase is known as the synthesis phase. During this phase DNA will begin to replicated, as well as the synthesis of the centrosomes and associated proteins.
-
This question is part of the following fields:
- Genetics
- Medicine
-
-
Question 8
Incorrect
-
Regarding cardiac output, an increased ejection fraction results from increases in which of the following?
Your Answer:
Correct Answer: Strength of contraction without increase in muscle fiber length
Explanation:When the strength of contraction increases without an increase in fiber length, the EF increases.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 9
Incorrect
-
A deficiency in Cyanocobalamin leads to which clinical deficiency syndrome?
Your Answer:
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
-
-
Question 10
Incorrect
-
Which of the following statements correctly describes a function of the parasympathetic innervation of the GI tract.
Your Answer:
Correct Answer: Parasympathetic cholinergic activity increases the activity of intestinal smooth muscle
Explanation:The parasympathetic nerves stimulate peristalsis and relax the sphincters; they also stimulate secretion. Acetylcholine is the neurotransmitter of the parasympathetic system.
-
This question is part of the following fields:
- Gastrointestinal
- Medicine
-
-
Question 11
Incorrect
-
A 72-year-old with varicose veins complains of swollen, red, itchy legs. Which is the most likely diagnosis?
Your Answer:
Correct Answer: Varicose eczema
Explanation:Varicose eczema is a common problem, particularly in elderly patients due to stasis or blood pooling from insufficient venous return; the alternative name of varicose eczema comes from a common cause of this being varicose veins. It is often mistaken for cellulitis, but cellulitis is rarely bilateral and is painful rather than itchy.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 12
Incorrect
-
A case-control study is being designed to look at the relationship between eczema and a new vaccine for yellow fever. What is the usual outcome measure in a case-control study?
Your Answer:
Correct Answer: Odds ratio
Explanation:A case–control study (also known as case–referent study) is a type of observational study in which two existing groups differing in outcome are identified and compared on the basis of some supposed causal attribute. Case–control studies are often used to identify factors that may contribute to a medical condition by comparing subjects who have that condition/disease (the cases) with patients who do not have the condition/disease but are otherwise similar (the controls).An odds ratio (OR) is a statistic that quantifies the strength of the association between two events, A and B. The odds ratio is defined as the ratio of the odds of A in the presence of B and the odds of A in the absence of B or vice versa.
-
This question is part of the following fields:
- Medicine
- Research Skills
-
-
Question 13
Incorrect
-
An important enzyme in renal tissue responsible for the conversion of glutamine to glutamate and the subsequent production of NH4 is called?
Your Answer:
Correct Answer: Glutaminase
Explanation:Glutaminase catalyses the following reaction:Glutamine + H2O → Glutamate + NH3
-
This question is part of the following fields:
- Medicine
- Renal
-
-
Question 14
Incorrect
-
All of the following features may suggest malignant changes in a melanocytic naevi, EXCEPT?
Your Answer:
Correct Answer: Decrease in size
Explanation:Melanocytic naevi are skin tumours produced by melanocytes. They usually present in childhood but increase during puberty. The mnemonic A-B-C-D, is used by institutions to assess for suspicion of malignancy. The letters stand for asymmetry, border, colour, and diameter. If a mole starts changing in size, colour, shape or, especially, if the border of a mole develops ragged edges or becomes larger than a pencil eraser, it would be an appropriate time to consult with a physician. Other warning signs include if it begins to crust over, bleed, itch, or become inflamed.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 15
Incorrect
-
Vitamin B12 is transported from the enterocytes to the bone marrow by which factor?
Your Answer:
Correct Answer: Transcobalamin II (TC IIi)
Explanation:B12 must be attached to 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. Once the IF/B12 complex is recognized by specialized ileal receptors, it is transported into the portal circulation. The vitamin is then transferred to transcobalamin II (TC-II/B12), which serves as the plasma transporter.
-
This question is part of the following fields:
- Haematology
- Medicine
-
-
Question 16
Incorrect
-
The axons of the POST ganglionic neurons are mostly?
Your Answer:
Correct Answer: C fibers
Explanation:According to Erlanger- Grasser classification preganglionic fibers are B fibers whereas post ganglionic fibers are C fibers.
-
This question is part of the following fields:
- Medicine
- Neurology
-
-
Question 17
Incorrect
-
The residual cleft of the intermediate lobe of the pituitary is lined by follicles resembling which human gland?
Your Answer:
Correct Answer: Thyroid
Explanation:The cells located between the two main pituitary lobes form what is known as the intermediate pituitary. This area secretes melanocyte-stimulating hormone and it is only a few cell layers thick. It is rich in follicles filled with colloid, and lined by basophilic cells. This configuration resembles that of another important gland: the thyroid.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 18
Incorrect
-
Which of the following features occurs very less frequently with drug induced lupus?
Your Answer:
Correct Answer: Glomerulonephritis
Explanation:Drug induced lupus typically presents with pulmonary involvement and no renal or neurological involvement. Hence glomerulonephritis would be highly unlikely in this case. Rash and arthralgias are classic presentations. Pleurisy can be present as pulmonary involvement may occur with DILE.
-
This question is part of the following fields:
- Connective Tissue
- Medicine
-
-
Question 19
Incorrect
-
Antibiotic resistance may happen by:
Your Answer:
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.
-
This question is part of the following fields:
- Infectious Diseases
- Medicine
-
-
Question 20
Incorrect
-
The actions of dihydrotestosterone in male reproductive physiology include:
Your Answer:
Correct Answer: Development of external genitalia in utero and at puberty
Explanation:Dihydrotestosterone mediates the differentiation of the urogenital sinus and genital tubercles, leading to the fusion of the urethral and labial folds; thus, it leads to the development of external genitalia in the male.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 21
Incorrect
-
In ventricular fibrillation (VF), the first defibrillation attempt (with a biphasic defibrillator) should be made at:
Your Answer:
Correct Answer: 200 J
Explanation:Defibrillation is a common treatment for life-threatening cardiac dysrhythmias and ventricular fibrillation. If the patient is in Ventricular tachycardia (VT) or ventricular fibrillation (VF) on the monitor, immediately apply the pads and shock the patient with 120-200 Joules on a biphasic defibrillator or 360 Joules on a monophasic defibrillator.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 22
Incorrect
-
A 22 year old man is being evaluated for chronic lower backache. Which of the following would most strongly point towards the diagnosis of ankylosing spondylitis?
Your Answer:
Correct Answer: Reduced lateral flexion of the lumbar spine
Explanation:Ankylosing spondylitis (spondylarthritis) is a chronic inflammatory disease of the axial skeleton that leads to partial or even complete fusion and rigidity of the spine. Males are disproportionately affected and upwards of 90% of patients are positive for the HLA-B27 genotype, which predisposes to the disease. The most characteristic early finding is pain and stiffness in the neck and lower back, caused by inflammation of the vertebral column and the sacroiliac joints. The pain typically improves with activity and is especially prominent at night. Other articular findings include tenderness to percussion and displacement of the sacroiliac joints (Mennell’s sign), as well as limited spine mobility, which can progress to restrictive pulmonary disease. The most common extra-articular manifestation is acute, unilateral anterior uveitis. Diagnosis is primarily based on symptoms and x-ray of the sacroiliac joints, with HLA-B27 testing and MRI reserved for inconclusive cases. There is no curative treatment, but regular physiotherapy can slow progression of the disease. Additionally, NSAIDs and/or tumour necrosis factor-α inhibitors may improve symptoms. In severe cases, surgery may be considered to improve quality of life. The spine adopts a bamboo shape, not lordosis. The pain usually improves as the day progresses. leg raise test causes pain in cases of meningitis etc not in this case.
-
This question is part of the following fields:
- Connective Tissue
- Medicine
-
-
Question 23
Incorrect
-
A 20 year old male student presents to the clinic with swelling of his face, hands and feet along with diffuse abdominal pain. He has a history of similar recurrent episodes since he was 10 years old, with each episode lasting 2-3 days. Examination reveals swelling on face, hands, feet but no sign of urticaria. Family history is significant for similar episodes in the mother who experienced these since childhood, and a brother who passed away following respiratory distress at age of 8 during one such episode. Which of the following tests would be the most helpful in reaching the diagnosis?
Your Answer:
Correct Answer: C1 esterase inhibitor
Explanation:Hereditary C1 inhibitor deficiency leads to recurrent angioedema without urticaria or pruritus. Physical triggers include dental work, surgery or intubation. Medical triggers include angiotensin-converting enzyme (ACE) inhibitor, tamoxifen, oestrogen-containing medications (e.g., hormone replacement therapy and oral contraceptives). It is diagnosed on the basis of low levels of C1 esterase inhibitor or elevated levels of dysfunctional C1 esterase inhibitor. C4 levels are low between attacks. IgE levels, eosinophils, skin prick tests and RASTs are helpful in other allergic conditions and asthma but not of use in this case.
-
This question is part of the following fields:
- Connective Tissue
- Medicine
-
-
Question 24
Incorrect
-
Which one of the following will increase an individual’s appetite?
Your Answer:
Correct Answer: Ghrelin
Explanation:Ghrelin is a hormone which exerts a strong influence on hunger and energy balance. It helps regulate appetite by being secreted when the stomach is empty, to stimulate hunger. When the stomach is filled, its secretion stops.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 25
Incorrect
-
What is the main function of vitamin E?
Your Answer:
Correct Answer: It is an antioxidant
Explanation:Vitamin E has many biological functions, the antioxidant function being the best known. Other functions include enzymatic activities, gene expression, and neurological function(s).
-
This question is part of the following fields:
- Haematology
- Medicine
-
-
Question 26
Incorrect
-
A 45-year-old male is brought to the emergency department after being found collapsed, outside a nightclub. The ER team found an empty bottle of amyl nitrate in his pocket. The patient is hypoxic with an O2 saturation of 84% and is confused. Which of the following is the best treatment for this patient?
Your Answer:
Correct Answer: Methylene blue
Explanation:The best treatment for the patient in question would be methylene blue.The most probable diagnosis in this patient is methemoglobinemia due to the ingestion of amyl nitrate.Amyl nitrate promotes the formation of methaemoglobin, which avidly conserves oxygen and leads to decreased tissue oxygen saturations. Treatment of choice includes methylene blue and vitamin C.Adverse effects:Benign side effects include green or blue discoloration of urine and patients should be forewarned. Significant side effects are based on methylene blue, itself, being an oxidizing agent and an inhibitor of monoamine oxidase A (MAO-A). As an oxidizing agent, methylene blue can actually precipitate methemoglobinemia or haemolysis in high doses or when ineffectively reduced. Methylene blue administration in a patient taking a serotonergic agents may predispose to serotonin syndrome.Note: Although methylene blue administration is controversial in the setting of G6PD-deficiency due to reduced levels of NADPH, it is not contraindicated and should be administered cautiously and judiciously.
-
This question is part of the following fields:
- Medicine
- Pharmacology
-
-
Question 27
Incorrect
-
Coronary arteries fill up during
Your Answer:
Correct Answer: Diastole
Explanation:During contraction of the ventricular myocardium (systole), the subendocardial coronary vessels (the vessels that enter the myocardium) are compressed due to the high ventricular pressures. This compression results in momentary retrograde blood flow (i.e., blood flows backward toward the aorta) which further inhibits perfusion of myocardium during systole. However, the epicardial coronary vessels (the vessels that run along the outer surface of the heart) remain open. Because of this, blood flow in the sub endocardium stops during ventricular contraction. As a result, most myocardial perfusion occurs during heart relaxation (diastole) when the subendocardial coronary vessels are open and under lower pressure.
-
This question is part of the following fields:
- Cardiovascular
- Medicine
-
-
Question 28
Incorrect
-
What is the function of migrating motor complex
Your Answer:
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.
-
This question is part of the following fields:
- Gastrointestinal
- Medicine
-
-
Question 29
Incorrect
-
During which phase of the cell cycle does DNA synthesis occur?
Your Answer:
Correct Answer: S
Explanation:DNA synthesis occurs in the S phase of the cell cycle. In the G1 phase the cell prepares to divide. In G2 the cellular organelles divide and in the M phase mitosis occur. In the G0 phase the cell becomes quiescent and does not divide further
-
This question is part of the following fields:
- Genetics
- Medicine
-
-
Question 30
Incorrect
-
What is the blood supply to the liver?
Your Answer:
Correct Answer: Hepatic artery and hepatic portal vein
Explanation:The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers approximately 75% of the liver’s blood supply, and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow. Oxygen is provided from both sources; approximately half of the liver’s oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries
-
This question is part of the following fields:
- Hepatobiliary
- Medicine
-
SESSION STATS - PERFORMANCE PER SPECIALTY
