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Question 1
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Question 2
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A 51 year old female presents with a sensation of grittiness in her eyes which has been present for the past few months. She also complains of symptoms of a dry mouth. On examination, she is seen with a swelling of her parotid gland. However, she has no evidence of facial nerve palsy. Which of the following is the most likely underlying diagnosis?
Your Answer: Sjogren's syndrome
Explanation:Sjogren syndrome (SS) is a long-term autoimmune disease that affects the body’s moisture-producing glands. Primary symptoms are a dry mouth and dry eyes. Other symptoms can include dry skin, vaginal dryness, a chronic cough, numbness in the arms and legs, feeling tired, muscle and joint pains, and thyroid problems. Those affected are at an increased risk (5%) of lymphoma. It primarily affects women in their peri and post-menopausal years of life.
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This question is part of the following fields:
- Head & Neck
- Pathology
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Question 3
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The V wave in the jugular pulse is caused by:
Your Answer: Atrial filling
Explanation:The V wave indicates the rise in the atrial pressure due to filling of the atria with blood before the tricuspid valve opens during the diastolic phase of contraction.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 4
Correct
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The net effect of parathyroid hormone on calcium and phosphate homeostasis is?
Your Answer: Increase in Ca, decrease in phosphate
Explanation:Parathyroid hormone’s main target organs are the kidneys, bone, and intestine. In the kidney, it decreases reabsorption of phosphate and increases calcium reabsorption. It also promotes absorption of calcium from bone. PTH release results in a small drop in serum phosphate concentrations.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 5
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Which mechanism of action does Quinolones use?
Your Answer: Inhibit DNA gyrase
Explanation:The quinolones are a family of synthetic broad-spectrum antibiotic drugs. Quinolones exert their antibacterial effect by preventing bacterial DNA from unwinding and duplicating.
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This question is part of the following fields:
- Infectious Diseases
- Physiology
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Question 6
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A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from the steering wheel of his car after falling asleep while driving headlong into an oncoming HGV lorry. Bruising around his sternum was observed, which appears to be the central point of impact. Which of the following structures is most likely injured by the blunt force trauma?
Your Answer: Right ventricle
Explanation:In its typical anatomical orientation, the heart has 5 surfaces formed by different internal divisions of the heart: Anterior (or sternocostal) – Right ventricle Posterior (or base) – Left atrium Inferior (or diaphragmatic) – Left and right ventricles Right pulmonary – Right atrium Left pulmonary – Left ventricle
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 7
Correct
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A 70 year old women, died suddenly. She had a history of hypertension and aortic stenosis. On autopsy her heart weighed 550g. What is the most likely cause of this pathology?
Your Answer: Hypertrophy
Explanation:Due to increased pressure on the heart as a result of hypertension and aortic stenosis, the myocardial fibres hypertrophied to adapt to the increased pressure and to effectively circulate blood around the body. Hyperplasia could not occur, as myocardial fibres are stable cells and cannot divide further. Fat does not deposit in the heart due to volume overload. Myocardial oedema is not characteristic of a myocardial injury. Metaplasia is a change in the type of epithelium. Atrophy would result in a decreased heart size and inability to function.
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This question is part of the following fields:
- Cell Injury & Wound Healing
- Pathology
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Question 8
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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:
- Metabolism
- Physiology
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Question 9
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:
- Neurology
- Physiology
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Question 10
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Restriction Enzymes...
Your Answer: Cut DNA sequences at specific sites
Explanation:Restriction endonucleases are enzymes that recognise short sequences of double stranded DNA and cut them at specific nucleotide points or sequences. These sequences differ for different restriction endonucleases.
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This question is part of the following fields:
- Genetics
- Physiology
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Question 11
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Phosphorylation of glucose once it enters the cell is catalysed by which enzyme?
Your Answer: Hexokinase
Explanation:Glucose 6-phosphate is produced by phosphorylation of glucose on the sixth carbon. This is catalysed by the enzyme hexokinase in most cells. One molecule of ATP is consumed in this reaction.
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This question is part of the following fields:
- Metabolism
- Physiology
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Question 12
Incorrect
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In which stage of mitosis are the chromosomes most obvious or prominent?
Your Answer: Anaphase
Correct Answer: Metaphase
Explanation:Prophase begins when the nucleus envelope disintegrates and the chromosomes start to condense. The chromosomes consist of two sister chromatids that are joined at a constriction known as centromere. When the cell reaches the metaphase the chromosomes are completely condensed and ready to align on the equatorial plate.
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This question is part of the following fields:
- Genetics
- Physiology
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Question 13
Correct
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The Sinoatrial node in the majority of people is supplied by the?
Your Answer: Right coronary artery
Explanation:In 60% of people, the SA node is supplied by the right coronary artery branch and in 40% of the people by the left coronary artery.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 14
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Critical shortening of Telomeres result in:
Your Answer: Inactivation of p 53 and prb and cell crisis
Explanation:Telomere length shortens with age. Progressive shortening of telomeres leads to senescence, apoptosis, or oncogenic transformation of somatic cells, affecting the health and lifespan of an individual. Telomeres prevent the chromosomes from shortening and prevent the coding portion of the DNA from being lost, thus allowing the cell to replicate indefinitely. During replication telomeres may be lost resulting in cell death.
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This question is part of the following fields:
- Genetics
- Physiology
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Question 15
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Absorption of fructose is via:
Your Answer: Facilitated diffusion
Explanation:Dietary fructose may be ingested as a monosaccharide or as a disaccharide. Sucrose is hydrolysed by sucrase to produce equal amounts of glucose and fructose and in this form, is usually completely absorbed. Fructose is mostly absorbed in the small intestine through GLUT-5 transporter mediated facilitative diffusion. This is an energy independent process.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 16
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The cell membrane:
Your Answer: Is a bilayer of amphipathic lipids
Explanation:The cell membrane consists of a bilayer of amphipathic lipids with embedded proteins. The basic function of the cell membrane is to protect the cell from its surroundings. It is selectively permeable to ions and organic molecules. The entire membrane is held together via non-covalent interaction of hydrophobic tails, however the structure is quite fluid and not fixed rigidly in place. Membranes are typically 7.5–10 nm in thickness and typically have a large content of proteins, around 50% of membrane volume.
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This question is part of the following fields:
- Cell Biology
- Physiology
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Question 17
Correct
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The role of the hemidesmosome is?
Your Answer: Attaches cells to underlying basal lamina
Explanation:Hemidesmosomes connect the basal surface of epithelial cells via intermediate filaments to the underlying basal lamina. The transmembrane proteins of hemidesmosomes are not cadherins, but another type of protein called integrin.
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This question is part of the following fields:
- Cell Biology
- Physiology
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Question 18
Correct
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The hepatic portal vein:
Your Answer: Carries mainly nutrients from the GIT.
Explanation:The portal vein contains oxygen as any other vein in the body does. The hepatic veins are responsible for venous drainage of the liver. The main function of the portal vein is to carry absorbed nutrients in the gut for metabolism and detoxification.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 19
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Where is intrinsic factor secreted?
Your Answer: Gastric parietal cells
Explanation:Intrinsic factor (IF), also known as gastric intrinsic factor (GIF), is a glycoprotein produced by the parietal cells of the stomach. It is necessary for the absorption of vitamin B12 (cobalamin) later on in the small intestine.
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This question is part of the following fields:
- Haematology
- Physiology
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Question 20
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The action potential is generated by excitable tissues, which are specialized tissues that can generate a meaningful electrical signal. Local currents transport action potentials down the axons of neurons. Which of the following claims about the action potential's conduction is correct?
Your Answer: The areas of the membrane that have recently depolarised will not depolarise again due to the refractory period
Explanation:Local currents propagate action potentials down the axons of neurons. Following depolarization, this local current flow depolarizes the next axonal membrane, and when this region crosses the threshold, more action potentials are formed, and so on. Due to the refractory period, portions of the membrane that have recently depolarized will not depolarize again, resulting in the action potential only being able to go in one direction. The square root of axonal diameter determines the velocity of the action potential; the axons with the biggest diameter have the quickest conduction velocities. When a neuron is myelinated, the speed of the action potential rises as well. The myelin sheath is an insulating coating that surrounds certain neural axons. By increasing membrane resistance and decreasing membrane capacitance, the myelin coating increases conduction. This enables faster electrical signal transmission via a neuron, making them more energy-efficient than non-myelinated neuronal axons. Nodes of Ranvier are periodic holes in a myelinate axon when there is no myelin and the axonal membrane is exposed. There are no gated ion channels in the portion of the axon covered by the myelin sheath, but there is a high density of ion channels in the Nodes of Ranvier. Action potentials can only arise at the nodes as a result of this. Electrical impulses are quickly transmitted from one node to the next, causing depolarization of the membrane above the threshold and triggering another action potential, which is then transmitted to the next node. An action potential is rapidly conducted down a neuron in this manner. Saltatory conduction is the term for this.
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This question is part of the following fields:
- Cell Biology
- Physiology
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Question 21
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
- Physiology
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Question 22
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Which of the following best describes the cardiac muscle?
Your Answer: Striated and involuntary
Explanation:Cardiac muscle (heart muscle) is an involuntary, striated muscle that is found in the walls and histological foundation of the heart, specifically the myocardium. Cardiac muscle is one of three major types of muscle, the others being skeletal and smooth muscle.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 23
Correct
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During uterogrowth, the second branchial arch gives rise to which structures?
Your Answer: Stylohyoid muscle
Explanation:The second pharyngeal arch or hyoid arch, is the second of six pharyngeal arches that develops in fetal life during the fourth week of development and assists in forming the side and front of the neck. Derivatives: Skeletal – From the cartilage of the second arch arises: Stapes, Temporal styloid process, Stylohyoid ligament, and Lesser cornu of the hyoid bone.Muscles: Muscles of face Occipitofrontalis muscle Platysma Stylohyoid muscle Posterior belly of Digastric Stapedius muscle Auricular musclesNerve supply: Facial nerve
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 24
Correct
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A 23-year-old student presents with a fever and sore throat. Upon physical examination, it was observed that he had bilaterally enlarged tonsils that are covered in large amounts of exudate. A diagnosis of tonsillitis was made. The lymph from the tonsils will drain to which of the following nodes?
Your Answer: Deep cervical lymph nodes
Explanation:The tonsils are collections of lymphatic tissue located within the pharynx. They collectively form a ringed arrangement, known as Waldeyer’s ring: pharyngeal tonsil, 2 tubal tonsils, 2 palatine tonsils, and the lingual tonsil. Lymphatic fluid from the lingual tonsil drains into the jugulodigastric and deep cervical lymph nodes. Lymphatic fluid from the pharyngeal tonsil drains into the retropharyngeal nodes (which empty into the deep cervical chain), and directly into deep cervical nodes within the parapharyngeal space. The retropharyngeal and the deep cervical lymph nodes drain the tubal tonsils. The palatine tonsils drain to the jugulodigastric node, a node of the deep cervical lymph nodes, located inferior to the angle of the mandible.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 25
Correct
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Which of the following is NOT an effect of cytokine activity:
Your Answer: Opsonisation of bacteria for phagocytosis
Explanation:Cytokines are a family of chemical messengers, secreted by leucocytes, that act over short distances by binding specific receptors on target cell surfaces. They include: interleukins (act between leucocytes), interferons (inhibit replication of viruses within cells and activate macrophages and natural killer cells), growth factors, and tumour necrosis factors (kill tumour cells). Effects include: induction of fever and acute phase response, stimulation of leucocyte differentiation and maturation, leucocyte recruitment and activation and increased antibody production.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 26
Incorrect
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Visceral afferent fibers are found in the following areas except the…?
Your Answer: Vagus nerve
Correct Answer: Trigeminal nerve
Explanation:The general visceral afferent (GVA) fibers carry impulses from viscera to the central nervous system. The cranial nerves that contain GVA fibers include the facial nerve, the glossopharyngeal nerve and the vagus nerve
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This question is part of the following fields:
- Neurology
- Physiology
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Question 27
Correct
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The following is true of the sinus node:
Your Answer: It generates impulses automatically & at a quicker rate than other cardiac cells
Explanation:The SA node exhibits automaticity. It generates the impulses to which the heart beats. It fires at a faster speed than the rest of the nervous components of the heart i.e. the AV nodes, purkinje fibers. This is the reason when the SA node fails the heart beats to the rhythm of the AV node.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 28
Correct
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A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck. Which of the following muscles is most likely to be involved? Select ONE answer only.
Your Answer: Anterior scalene
Explanation:The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains: Muscles: thyrohyoid, sternothyroid, sternohyoid muscles Organs: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid gland Arteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteries Veins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veins Nerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerve The posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle. Contents: Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodes Nerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexus Of the muscles listed in the options, only the anterior scalene is situated within the posterior triangle of the neck.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 29
Correct
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Choose the most correct answer, what reduces affinity for oxygen in haemoglobin?
Your Answer: All the options are true
Explanation:The strength with which oxygen binds to haemoglobin is affected by several factors. These factors shift or reshape the oxyhaemoglobin dissociation curve. A rightward shift indicates that the haemoglobin under study has a decreased affinity for oxygen. The causes of shift to right can be remembered using the mnemonic, CADET, face Right! for CO2 and CO, Acid (H+), 2,3-DPG, Exercise and Temperature.
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This question is part of the following fields:
- Haematology
- Physiology
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Question 30
Correct
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Which neurotransmitter is made from hydroxylation and decarboxylation of tryptophan?
Your Answer: Serotonin
Explanation:Serotonin is synthesized from the essential amino acid tryptophan. The rate-limiting step is the conversion of the amino acid to 5-hydroxytryptophan by tryptophan hydroxylase. This is then converted to serotonin by the aromatic L-amino acid decarboxylase.
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This question is part of the following fields:
- Neurology
- Physiology
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